GK双叶机械瓣应用于二尖瓣置换术机械功能评价的病例对照研究  

Application of GK Bileaflet Mechanical Valve in Mitral Valve Replacement:A Case Control Study

作　　者：张伟华[1] 李杰[1] 张新[1] 张亮[1] 朱耀斌[2] 罗鸿[1] 马宁 刘东海[1] 臧素华[1] 乔晨晖[1] 李继峰 

机构地区：[1]郑州大学第一附属医院心血管外科,郑州450052 [2]首都医科大学附属北京安贞医院小儿心脏中心,北京100029 [3]郑州颐和医院心血管外科,郑州450047

出　　处：《中国胸心血管外科临床杂志》2016年第10期965-968,共4页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

基　　金：国家自然科学基金(81371443);河南省科技厅科技攻关项目(142102310346)~~

摘　　要：目的 评价GK双叶机械瓣应用于二尖瓣置换术近中期的机械功能。方法 选取我院自2008年3月至2011年6月收治的以风湿性二尖瓣狭窄为主要病变的20例患者。其中10例应用GK双叶机械瓣行二尖瓣置换术（GK组）,男5例、女5例,年龄40~69（56.4±8.9）岁;另10例应用Medtronic Open Pivot机械瓣行二尖瓣置换术（Medtronic组）,男4例、女6例,年龄30~69（50.2±8.0）岁。比较两组术前基础资料、术中及术后资料。术后3年通过心脏CT血管造影评价人工机械瓣膜的在体形态和瓣叶开放角度,经胸超声心动图测定两组患者的血流动力学指标。结果 两组患者均无术后死亡,无瓣周漏、低心排血量综合征及二次开胸止血等并发症发生。所有患者3年随访资料显示,术后近中期的机械瓣膜功能无明显差异,未见血栓形成及人工机械瓣膜功能障碍,心脏CT血管造影及心脏彩超检查示两组患者人工机械瓣膜的在体形态良好。结论 二尖瓣置换术后3年GK双叶机械瓣膜具有良好的机械瓣膜功能,与Medtronic双叶机械瓣效果相当。Objective To evaluate the early and mid-term outcomes of GK bileaflet mechanical valve applied in mitral valve replacement. Method Twenty patients with rheumatic mitral stenosis underwent mitral valve replacement in our hospital from March 2008 to June 2011. Ten patients of them chose GK bileaflet mechanical valve for surgery （a GK group, 5 males and 5 females, aged 56.4＋8.9 years）, while the other 10 patients chose Medtronic Open Pivot mechanical valve （a Medtronic group, 4 males and 6 females, aged 50.2_＋8.0 years）. The preoperative, perioperative and postoperative data were analyzed and compared between the two groups. Cardiac CT angiography （CTA） and transesophageal echocardiography （TEE） were performed to evaluate leaflets opening angle, the morphological features of the mechanical valve and the hemodynamic features in the third year after surgery during the follow-up. Result No mortality, defect, low cardiac output syndrome or bleeding after surgery occurred in either group. The result of 3-year follow-up showed that the function of the mechanical valve showed no difference between the two groups. Cardiac CTA and TEE showed good morphological features in all patients. Conclusion The GK bileaflet mechanical valve has equivalent effect as Medtronic Open Pivot mechanical valve for mitral valve replacement during the 3-year follow-up.

关 键 词：GK双叶机械瓣 二尖瓣置换 功能评价 

分 类 号：R654.2[医药卫生—外科学]