Application of Regent mechanical valve in patients with small aortic annulus: 3-year follow-up.
Application of Regent mechanical valve in patients with small aortic annulus: 3-year follow-up.
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Regent机械瓣膜在小主动脉瓣环患者中的应用：3年随访
DOI：
10.1186/1749-8090-7-88
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发表时间：
2012-09-21
影响因子：
1.6
通讯作者：
Guo C
中科院分区：
文献类型：
--
作者：
Zhao D;Wang C;Hong T;Pan C;Guo C
背景小主动脉瓣环的主动脉瓣置换术（AVR）一直是心脏外科医生的难题。在本研究中，我们试图评价使用17 mm或19 mm St. Jude Medical Regent植入的中期性能（SJM Regent）机械瓣膜在小主动脉瓣环患者的回顾性连续队列中的应用方法2008年1月至2011年4月，（31例女性，平均年龄= 47.2 ± 5.8岁），主动脉瓣环较小（直径≤19 mm），采用17 mm或19 mm St. Jude Medical Regent（SJM Regent）机械瓣膜。术前平均体表面积、纽约心脏协会分级和平均主动脉瓣环分别为1.61 ± 0.26 m2、3.2 ± 0.4和18 ± 1.4 mm。根据植入17 mm SJM Regent机械瓣膜（组1，n = 18）或19 mm SJM Regent瓣膜（组2，n = 22）将患者分为两组。所有患者术前和术后1年进行超声心动图检查。随访时间平均36 ± 17.6个月。术后平均纽约心脏协会分级为1.3 ± 0.6（p < 0.001）。超声心动图显示，第1组的左室射血分数（LVEF）、左室短轴缩短率（LVFS）和有效瓣口面积指数（EOAI）分别从43.7% ± 11.6%、27.3% ± 7.6%和0.70 ± 0.06 cm 2/m2增加到69.8 ± 9.3%、41.4 ± 8.3%，和0.92 ± 0.10 cm 2/m2（P< 0.05），左心室质量指数（LVMI）和主动脉跨瓣压差分别从116.4 ± 25.4 g/m2、46.1 ± 8.5 mmHg降至86.7 ± 18.2 g/m2、13.7 ± 5.2 mmHg。在第2组中，LVEF、LVFS和EOAI分别从45.9% ± 9.7%、30.7% ± 8.0%和0.81 ± 0.09 cm 2/m2增加到77.4% ± 9.7%、44.5% ± 9.6%和1.27 ± 0.11 cm 2/m2，而LVMI、主动脉跨瓣压差由术前的118.3 ± 27.6 g/m2、44.0 ± 6.7 mmHg降至80.1 ± 19.7 g/m2、10.8 ± 4.1 mmHg。第1组中有2例患者发生PPM。结论主动脉瓣环和体表面积较小的患者，采用现代SJM Regent双叶瓣置换术后，临床症状得到了满意的改善。
BackgroundAortic valve replacement (AVR) with a small aortic annulus is always challenging for the cardiac surgeon. In this study, we sought to evaluate the midterm performance of implantation with a 17-mm or 19-mm St. Jude Medical Regent (SJM Regent) mechanical valve in retrospective consecutive cohort of patients with small aortic annulus (diameter ≤ 19 mm).MethodsFrom January 2008 to April 2011, 40 patients (31 female, mean age = 47.2 ± 5.8 years) with small aortic annulus (≤19 mm in diameter) underwent aortic valve replacement with a 17-mm or 19-mm St. Jude Medical Regent (SJM Regent) mechanical valve. Preoperative mean body surface area, New York Heart Association class, and mean aortic annulus were 1.61 ± 0.26 m2, 3.2 ± 0.4, and 18 ± 1.4 mm respectively. Patients were divided into two groups, according to the implantation of 17 mm SJM Regent mechanical valve (group 1, n = 18) or 19 mm SJM Regent valve (group 2, n = 22). All patients underwent echocardiography examination preoperatively and at one year post-operation.ResultsThere were no early deaths in either group. Follow-up time averaged 36 ± 17.6 months. The mean postoperative New York Heart Association class was 1.3 ± 0.6 (p < 0.001). By echocardiography, in group 1, the left ventricular ejection fraction (LVEF), left ventricular fraction shortening (LVFS), and the indexed effective orifice area (EOAI) increased from 43.7% ± 11.6%, 27.3% ± 7.6%, and 0.70 ± 0.06 cm2/m2to 69.8 ± 9.3%, 41.4 ± 8.3%, and 0.92 ± 0.10 cm2/m2respectively (P< 0.05), while the left ventricular mass index (LVMI), and the aortic transvalvular pressure gradient decreased from 116.4 ± 25.4 g/m2, 46.1 ± 8.5 mmHg to 86.7 ± 18.2 g/m2, 13.7 ± 5.2 mmHg respectively. In group 2, the LVEF, LVFS and EOAI increased from 45.9% ± 9.7%, 30.7% ± 8.0%, and 0.81 ± 0.09 cm2/m2to 77.4% ± 9.7%, 44.5% ± 9.6%, and 1.27 ± 0.11 cm2/m2respectively, while the LVMI, and the aortic transvalvular pressure gradient decreased from 118.3 ± 27.6 g/m2, 44.0 ± 6.7 mmHg to 80.1 ± 19.7 g/m2, 10.8 ± 4.1 mmHg as well. The prevalence of PPM was documented in 2 patients in Group 1.ConclusionsPatients with small aortic annulus and body surface area, experienced satisfactory clinical improvement after aortic valve replacement with modern SJM Regent bileaflet prostheses.
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影响因子：
1.6
作者：
Minardi G;Manzara C;Creazzo V;Maselli D;Casali G;Pulignano G;Musumeci F
通讯作者：
Musumeci F
影响因子：
37.8
作者：
RAHIMTOOLA, SH
通讯作者：
RAHIMTOOLA, SH
影响因子：
24
作者：
Bakhtiary, Farhad;Schiemann, Mirko;Kleine, Peter
通讯作者：
Kleine, Peter
影响因子：
4.6
作者：
Okamura, Homare;Yamaguchi, Atsushi;Adachi, Hideo
通讯作者：
Adachi, Hideo
影响因子：
4.6
作者：
Sezai, Akira;Kasamaki, Yuji;Minami, Kazutomo
通讯作者：
Minami, Kazutomo