连续缝合法在主动脉瓣生物瓣置换术中的应用.pdfVIP

Vo l.43 No.3 第 43 卷第 3 期 温州医学院学报 2013 年 3 月 Journal of Wenzhou Medical College Ma r. 2013 醒E 疆 连续缝合法在主动脉瓣生物瓣置换术中的应用 郑亮承，手呈德志，孙成超 (温州医学院附属第一医院 心胸外科，浙江温州 325000) [摘 要]目的:总结连续缝合法在主动脉瓣生物瓣置换术中的应用经验。方法: 28 例心脏瓣膜病忠者， 单纯主动脉瓣置换术21 例，双瓣(主动脉瓣及二尖瓣)置换术7 例，均采用连续缝合法至换生物瓣。其中 置换上21 mm 生物瓣 1 例， 23 mm 19 例， 25 mm 8 例。结果:本组平均主动脉阻断时间 (87 :t 12) min , 单纯主动脉瓣直换，无主动脉瓣钙化者主动脉阻断时间 (36 土 4.6) min ，元主动脉瓣周漏，直换21 mm 生物瓣者跨主动脉瓣压差 48 mmHg ，其余患者3号主动脉瓣压差 (10 土 4.3) mmHg。结论:主动脉瓣生物瓣 置换中采取连续缝合法可置入比主动脉瓣瓣坏内径大 1 - 2 mm 的生物瓣，获得较大的有效瓣口面积，可以 有效降低跨瓣压力阶差，减轻左心室负荷，有利于心功能的恢复。 [关键词] 连续缝合法;主动脉瓣置换术;心脏瓣膜病;生物瓣 [中图分类号] R654.2 [文献标志码] A [文章编号] 1000一2138 (2013) 03-0184-03. Application of continuous suture technique for bioprosthetic aortic valve replacement ZHENG Liangcheng, CHENGDez为i， SUN Chengchao. Department ofCardiothoracic Surgeη the First Affiliated Hospital ofWenzhou Medical College, 仨nzhou， 325ω。 -h1mQB9 IW. Objective: To summarize the experience of continuous suture technique for bioprosthetic aortic valve (AV) replacement. Methods: Total 28 cases of heart valve disease , 21 阳tients underwent aortic valve replacement and the other 7 patients concomitant cardiac procedures including mitral valve repla四me时， and all the cases adopted the continuous suture technique to repalce the bioprosthetic aortic valve. 21 mm size aortic AV was used in lpatient, 23 mm size aortic AV was used in 19 patients and 25 mm size in 8 patients. Results: The mean duration of aortic cross-clamp was (87 士 12) min , and the m币an time was (36 土 4.6) min in the pure AV replace- ment cases withoutAV calcification. No perivalvular leakage was found after operation , the transvalvular pressure gradient in the