Perimount牛心包瓣在二尖瓣置换术后的短期疗效研究  

The short term outcome after mitral valve replacement with the perimount bovine pericardial valve

作　　者：田彦超 陈庆良[2] 陈彤云[2] 姜楠[2] 王联群[2] 

机构地区：[1]天津医科大学,300070 [2]天津市胸科医院

出　　处：《天津医药》2016年第6期776-779,共4页Tianjin Medical Journal

基　　金：天津市卫生局科技基金(11KG125)

摘　　要：目的评价Perimount牛心包瓣在患者二尖瓣置换术后的短期疗效情况。方法选取88例行Perimount牛心包瓣置换术患者,记录患者1年病死率、脑出血等一般情况。分别于术前、术后1周、3个月、1年行超声心动图检查,比较不同时间点患者纽约心脏病学会(NYHA)心功能分级、左心房直径(LA)、左室舒张末期直径(LVDD)、左室收缩末期直径(LVSD)、左心室射血分数(LVEF)及肺动脉压力(PAP)情况;术后1周、3个月及1年的最大跨瓣压差(PG)、平均跨瓣压差(MG)、最大跨瓣流速(PV)及有效瓣口面积(EOA)等血流动力学指标。结果 1年内有2例(2.3%)死亡,1例死于脑出血,1例死于血栓栓塞;瓣周漏1例(1.2%),无感染性心内膜炎和结构性瓣膜衰败发生。术后3个月及1年NYHA心功能分级改善(P<0.05)。与术前比较,术后1周、3个月及1年LA、LVDD、PAP均降低(P<0.05);术后1周LVSD、LVEF均降低(P<0.05);术后3个月及1年LVEF均升高(P<0.05)。与术后1周比较,术后3个月及1年LA、LVEF均升高(P<0.05)。患者术后1周、3个月与1年的PG、MG、PV及EOA比较差异均无统计学意义。结论 Perimount牛心包瓣应用于二尖瓣膜置换术后3个月和1年患者心功能恢复较好。Objective To evaluate the short term outcome after mitral valve replacement with the Perimount bovine pericardial valve. Methods Eighty-eight patients underwent mitral valve replacement with the bovine pericardial valve in hospital were included in this study. Postoperative general condition including mortality and cerebral hemorrhage was observed. The hemodynamic and New York heart disease association (NYHA) heart function classification were recorded by Doppler echocardiograms before operation, postoperative 1 week, 3 months and 1 year after mitral valve replacement. Values of the different time points of NYHA, left atrial diameter (LA), left ventricular end diastolic diameter (LVDD), left ventricular end systolic diameter (LVSD), left ventricular ejection fraction (LVEF) and pulmonary artery pressure (PAP) were compared. The hemodynamic parameters were also compared including the peak cross valve pressure (PG), mean cross valve pressure (MG), peak cross valve velocity (PV) and effective orifice area (EOA) 1 week, 3 months and 1 year after surgery. Results There were two cases (2.3%) dead in one year (one died of cerebral hemorrhage and another one died of thromboembolism). There was 1 perivalvular leakage (1.2%). There was no endocarditis or structural valve deterioration. NYHA cardiac function was improved at postoperative 3 months and 1 year (P < 0.05). The values of LA, LVDD and PAP were significantly decreased at postoperative 1 week, 3 months and 1 year compared with those before operation (P<0.05). Values of LVSD and LVEF were significantly decreased at postoperative 1 week compared with those before operation (P<0.05). The value of LVEF was significantly increased at postoperative 3 months and 1 year (P<0.05). Compared with postoperative 1 week, the values of LA and LVEF were significantly increased at postoperative 3 months and 1 year (P < 0.05). There were no significant differences in PG, MG, PV and EOA between postoperative 1 week, 3 months and 1 year. Conclusion With the excellent performance of ca

关 键 词：心脏瓣膜 人工 二尖瓣 超声心动图 血流动力学 心功能 有效瓣口面积 

分 类 号：R654.27[医药卫生—外科学]