瓣叶增补法在主动脉瓣成形术中的应用

目的 探讨瓣叶增补技术在主动脉瓣成形术中应用的效果.方法 2007年1月至2009年12月,应用瓣叶增补法完成主动脉瓣成形术26例,患者平均年龄11.5岁.术前四肢动脉压差58～103 mm Hg.主动脉瓣病变包括瓣叶脱垂或感染性心内膜炎造成的瓣叶损害;彩色多普勒显示主动脉瓣有中-重度反流.全组均在病变瓣叶边缘缝合心包片增补瓣叶形成正常瓣兜,使三个瓣叶边缘对合良好.结果 全组无手术及术后早期死亡.术后全组均无心力衰竭发生,动脉压差36～51 mm Hg.彩色超声心动图提示主动脉瓣无明显反流5例,有微少反流12例、轻度反流9例.随访3～38个月,复查超声心动图显示主动脉瓣无反流加重者.结论 瓣叶增补技术能有效地减少或避免主动脉瓣反流.

Application of valve leaflet adding technique in valvoplasty of aortic valve

Objective To investigate the efficacy of valve leaflet adding technique being used in valvo- plasty of aortic valve. Methods From Jan 2007 to Dec 2009, 26 cases of aortic valvoplasty whose age ranged from 5 to 38 years were performed with valve leaflet adding technique. The pulse pressure difference ranged from 58-103 mm Hg. The aortic valve insufficience from moderate to severe degree was caused by leaflet prolapse or damage of infection. Leaflet hood was shaped by suturing pericardium to the edge of lesion leaflet in each case, and three leaflets turned to close firmly. Results No case died in perioperative stage or in following up 3 to 38 months. The aortic valve close was greatly improved and remains stable. The pulse pressure difference changed to 36-51 mm Hg. Conclusion Valve leaflet adding technique can greatly decrease or avoid the insufficience of aortic valve.