免缝合异种主动脉生物瓣膜的实验研究

摘要

目的:研制新型免缝合异种主动脉生物瓣膜,并在体外将其与临床常用机械瓣膜进行初步比较研究.方法:将无支架猪主动脉瓣缝合到NiTi形状记忆合金支架上,并在TH-1200型人工心脏瓣膜体外脉动流实验台检测自制的25#的新型瓣膜和临床常用机械瓣膜的平均跨瓣压差、有效开口面积及返流百分比情况.结果:免缝合异种主动脉生物瓣膜的设计和制作方法达到人工瓣膜的技术要求.自制的25#的新型瓣膜在模拟心输出量为3、4和5 L/min的条件下进行测试的平均跨瓣压差(4.215 ± 0.220)、(5.168 ± 0.367)、(6.158 ± 0.487)mmHg,有效开口面积(1.998 ± 0.186)、(2.325 ± 0.387)、(3.184 ± 0.241)cm2及返流百分比(5.331 ± 0.284)%、(4.984 ± 0.521)%、(3.609 ± 0.264)%符合国家标准.且各项指标优于机械瓣膜的指标.结论:该型瓣膜具有血流动力学良好,跨瓣压小,无需抗凝等优点,且简化了手术操作,降低了手术难度.新型瓣膜总体性能优于临床常用机械瓣膜.%Objective To devise a new type of sutureless heterogeneity aorta biovalve , and compare the function of the new valve with meechanical valve in vitro. Methods Stitched up the stentless pig aorta valves into the NiTi memory alloy stents. The new type 25# valves were tested hy TH-1200 H.V. prosthesis pulsatile flow tester in vitro, which were compared with 25# mechanical valves. Mean transvalvular pressure gradient (MTPG), effective orifice area (EOA) and regurgitant fraction (RF) were tested in hoth valves. Results Devising and manufacturing methods of sutureless heterogeneity aorta biovalve have reached the criterion of China about artificial heart valve proshtesis. Under 3 (3,4,5 L/min)stimulant cardiac outputs, the MTPCJ of sutureless heterogeneity aorta biovalve were (4.215 ± 0.220) , (5.168±0.367) and (6.158 ± 0.487)mmHg, the EOA of sutureless heferogeneity aorta hiovalve were (1.998 ± 0.186) , (2.325 ± 0.387) and (3.184 ± 0.24l)cm2, and RF were (5.331 ± 0.284)％, (4.984 ± 0.521)％ and (3.609 ± 0.264)％ , respectively. All of them have reached the criterion of China about artificial heart valve proshtesis. Conclusion The new type of valve inherits excellent hlood dynamics of biovalve, including lower transvalvular pressure gradient, no need for anticoagulation, and more important, simplified the surgical operation and reduce the surgical operation difficulty. Its performance is superior to those of mechanical valves used commonly in practice.