重度主动脉瓣狭窄行膜置换术后.docVIP

重度主动脉瓣狭窄行瓣膜置换术后 左室流出道流速变化及影响因素分析 张丽选取重度主动脉瓣狭窄患者联合瓣膜病组分成两组(I组：术后LVOT流速增加；II组：术后LVOT流速未见明显增加)术前记录术随访超声心动图26例联合瓣膜病组2例发生LVOT流速增加，50例单纯性患者中则有1例出现此现象LVEDD、室间隔厚度与LVEDD比值左室流速增加患者，，6个月左右流速大都能恢复正常患者行瓣膜置换术流速增快发生率较高 关键词 主动脉瓣狭窄 主动脉瓣置换 超声心动图 左室流出道流速 Velocity variation and influence factor analysis of LVOT after AVR for severe AS Zhang li Xu zhen Yao liping Department of Cardiothoracic Surgery, Xinhua hospital Affiliated to Shanghai Jiao Tong University Medical School, Shanghai, China ABSTRACT Objective To explore the mechanism and related factors of LVOT Velocity speed after AVR for severe AS. Methods 76 patients after AVR for severe AS were enrolled in this study. Divided into combined valvular disease group and pure AS group. And then divided the pure AS group into another two groups (I: Velocity of LVOT speed up; II: Velocity of LVOT is not speed up). Preoperative record LVEDD、thickness of IVS、whether combined aortic malformation、Velocity of LVOT、EF of LV and follow-up Echocardiography Postoperative. Results 2 of 26 patients’ LVOT Velocity speed up after AVR with combined valvular disease, 18 of 50 patients’ LVOT Velocity speed up after AVR with pure AS disease. For pure AS, there are statistically significant difference between the two groups of the LVEDD and the ratio between IVS thickness and LVEDD. For 18 patients whose LVOT Velocity speed up after AVR with pure AS disease, the velocity increases quickest in 1week post-operation and be back to normal about 6 months. Conclusion The incidence of LVOT Velocity speed up after AVR for severe AS is high. Velocity is increasing first and then decreasing. It will be back to normal about 6 months. Mostly are pure AS patients pre-operation. Related to LVEDD and the ratio between IVS thickness and LVEDD. KEY WORDS aortic stenosis aortic valve replacement Echocardiography LVOT Velocity 重度主动脉瓣狭窄（AS aortic stenosis）患者病程长，瓣膜质量差，大多数在临床治疗中进行（AVR, aortic valve replacement）。已有报道证实部分患者术后左室流出道(LVO