Globits S, Rödler S, Mayr H, Moritz A, Mlczoch J, Glogar D, Wolner E
Department of Cardiology, University of Vienna, Austria.
J Card Surg. 1992 Mar;7(1):9-16. doi: 10.1111/j.1540-8191.1992.tb00772.x.
Between April 1989 and March 1991, 237 CarboMedics bileaflet valve prosthesis carriers (165 aortic and 72 mitral valves, mean age 54.4 years) were studied prospectively with pulsed- and continuous-wave Doppler at a mean interval of 11.4 months following surgery in order to establish ranges of normal flow velocities and pressure gradients. Physical examination revealed no signs of prosthetic dysfunction or heart failure. Postoperative left ventricular function as measured by fractional shortening was 37% for aortic valve carriers and 30% for mitral valve carriers (p = NS). Mean peak velocity (+/- SD) across the aortic valve was 2.6 m/sec (+/- 0.4) and calculated instantaneous peak pressure gradient ranged from 11 to 58 mmHg (mean 28.1 +/- 10.3). It has to be emphasized that occasional patients with normally functioning valve prostheses can show unusual high gradients. Ring diameters between 21 and 27 mm showed no significant difference with regard to flow velocities and pressure gradients, whereas in 19-mm valves, significantly higher values could be demonstrated. The 123 aortic valve carriers with normal left ventricular function (fractional shortening greater than 25%) showed significantly higher pressure gradients than the 19 patients with reduced left ventricular function (28.6 +/- 11.6 mmHg vs 16.2 +/- 5.1 mmHg, p less than 0.05). In the mitral position, the mean of peak velocity (+/- SD) was 1.7 +/- 0.4 m/sec and pressure half-time was 108 +/- 26 msec, representing a calculated valve area between 1.4 to 3.1 cm2 (mean orifice size 2.1 +/- 0.5 cm2). No significant difference between valves of different sizes was found.(ABSTRACT TRUNCATED AT 250 WORDS)
在1989年4月至1991年3月期间，对237例CarboMedics双叶瓣假体携带者（165例主动脉瓣和72例二尖瓣，平均年龄54.4岁）进行了前瞻性研究，术后平均间隔11.4个月采用脉冲波和连续波多普勒检查，以确定正常流速和压力阶差范围。体格检查未发现人工瓣膜功能障碍或心力衰竭的迹象。通过缩短分数测量的术后左心室功能，主动脉瓣携带者为37%，二尖瓣携带者为30%（p=无显著性差异）。主动脉瓣平均峰值流速（±标准差）为2.6米/秒（±0.4），计算出的瞬时峰值压力阶差范围为11至58毫米汞柱（平均28.1±10.3）。必须强调的是，偶尔有瓣膜假体功能正常的患者可能会出现异常高的压力阶差。21至27毫米的瓣环直径在流速和压力阶差方面无显著差异，而19毫米瓣膜的流速和压力阶差明显更高。123例左心室功能正常（缩短分数大于25%）的主动脉瓣携带者的压力阶差明显高于19例左心室功能降低的患者（28.6±11.6毫米汞柱对16.2±5.1毫米汞柱，p<0.05）。在二尖瓣位置，平均峰值流速（±标准差）为1.7±0.4米/秒，压力减半时间为108±26毫秒，计算出的瓣口面积在1.4至3.1平方厘米之间（平均开口大小2.1±0.5平方厘米）。不同尺寸瓣膜之间未发现显著差异。（摘要截短至250字）
