应用无支架Medtronic生物瓣行主动脉瓣替换

评估无支架Ｍｅｄｔｒｏｎｉｃ生物瓣作主动脉瓣替换的安全性和临床效果。方法以冠状动脉开口下方植入技术用无支架Ｍｅｄｔｒｏｎｉｃ生物瓣作主动脉瓣替换共８５例。易除左、右冠状动脉空运保留完整的无冠窦，全部采用连续缝合方法。结论无支架Ｍｅｄｔｒｏｎｉｃ生物瓣作主动脉瓣替换效果良好，适用于年龄超过７５岁以及伴有狭小动脉根部的病人。

Aortic Valve Replacement with Medtronic Freestyle Bioprosthesis

Aim:The purpose of the study was to evaluate the efficacy and safety of aortic valve replacement with medtronic freestyle bioprosthesis.Clinical material and method:The aortic valve was replaced with the medtronic freestyle bioprosthesis in 85 patients.The mean age of patients was 74 years(range,86 88 years).All bioprosthesis were implanted using the freehand subcoronary includes valve replacement technique,which includes removing the aortic sinus from the graft while leaving the non coronary sinus intact.Continuous suture technique was employed.Echocardiogram was performed to evaluate the function of the bioprosthesis during three year follow up.Results:There were four operative deaths with an operative mortality of 3.9%.Postoperative complications developed in 5 patients including central nervous system injury with paresis in 2,transient cerebral ischemia in 2 and upper gastrointestinal tract bleeding in 1.Late deaths occurred in 5 patients(4.7%).ECHO showed good hemodynamic performance of the prosthesis with low mean gradient(6 20mm Hg),and effective valve area(>0.9cm 2).The aortic valve was competent or with trifle incompetence by ECHO in 86% of patients one year after operation.Conclusion:These data show that the medtronic freestyle bioprosthesis is an excellent choice for replacement of the aortic valve,especially in patients over the age of 75 years or with small aortic root.