获得性主动脉瓣瓣膜病变的整形手术

目的为了恢复主动脉瓣的功能，总结４０例获得性主动脉瓣整形术的经验。方法对４０例获得性主动脉瓣病变进行整形手术，包括主动脉瓣边缘楔形削除、交界切开、钙化灶清除、穿孔修补及自体心包加宽瓣叶等整形手术。结果手术死亡率５％。单纯主动脉瓣关闭不全组术后反流面积明显减少；单纯主动脉瓣狭窄组或狭窄合并关闭不全组术后跨瓣压差明显下降，而后者反流加重。结论在获得性主动脉瓣病变中，瓣膜条件尚好的单纯关闭不全或狭窄可行整形矫正，而狭窄合并关闭不全者行整形难以恢复正常瓣膜功能

Valvuloplasty for Acquired Aortic Valve Disease

Objective To restore the function of aortic valves. Methods Forty cases of acquired aortic valve disease underwent valvuloplasty, including wedge resection of fibrous tissue on the edge of cuspids,commissurotomy, debridement of calcium deposits, extension of cuspids with autologous pericardium and the repair of perforation. Results The operative mortality was 5%.In cases with simple aortic insufficiency, regurgitation decreased significantly; in cases with simple aortic stenosis,or stenosis combined with regurgitation, the postoperative transvalvular pressure markedly decreased, but the latter showed augmented regurgitation. Conclusion Simple moderate aortic insufficiency and stenosis in acquired heart disease may be corrected by sculpturing the involved cuspids if the valves are suitable for valvuloplasty, while aortic stenosis with insufficiency is difficult to achieve normal valve function by this method.