摘要
目的探讨小主动脉瓣环（直径〈17mm）患者行17mm SJM Regent瓣置换术，术后是否产生不匹配（PPM）现象，以及早、中期疗效。方法13例单纯主动脉瓣狭窄（瓣环直径〈17mm）患者置换17mm SJM Regent瓣机械瓣，用彩色多普勒超声仪对左心功能进行术前、术后监测并与13例置换21mm常规机械瓣患者进行对比。结果无围术期死亡，随访6—36个月无瓣膜相关性并发症，3例患者出院时有中度PPM（EOAI〈0．85cm^2／m^2），13例患者术后跨瓣压差及左室心肌质量指数较术前均明显下降（P〈0．05），与常规21mm机械瓣患者比较差异无统计学意义。结论对于小主动脉瓣环（直径〈17mm）患者行17mm SJM Regent机械瓣置换是一种安全有效的选择，中度PPM对患者早中期预后无影响，无需进行主动脉根部扩大术。
Objective To investigated wheather the patients with small aortic ring （ diameter〈17mm ） were freedom from PPM4 and the early and mid-term outcomes after AVR with 17 mm SJM Regent mechanical prosthesis. Methods Thirteen patients with aortic valve stenosis （the annulus diameter〈17mm ） underwent AVR with 17mm SJM Regent mechanical prosthesis in our hospital from Jan 2010 to Jan 2013 . The patients were followed up for echocardiogram and cardiac functions, and the results were compared with those of randomly selected thirteen patients receiving 21 mm aortic mechanical prosthesis. Results There was no perioperative death in this group of patients, the follow-up of 6-36 months without valve related complications, 3 cases of patients with moderate PPM （ EOAI〈0.85cmE/m： ） . The two groups showed significant improvements in the left ventricular mass index, and aortic pressure gradient after operation （ P〈0.05 ） , and no significant differences were found in the two groups, without statistical difference. Conclusions AVR with 17mm SJM Regent mechanical prosthesis is a reliable choice for the patients with small aortic ring （ diameter 〈17 mm ） . No obvious prosthesis-patient mismatch occurs and aortic valve ring expansion is not necessary.
出处
《浙江临床医学》
2014年第6期849-851,共3页
Zhejiang Clinical Medical Journal
