Landay M J, Estrera A S, Bordlee R P
Department of Radiology, University of Texas, Southwestern Medical Center, Dallas 75235.
Radiographics. 1992 Jul;12(4):659-71. doi: 10.1148/radiographics.12.4.1636032.
Surgical methods for improving the function of diseased cardiac valves are valve reconstruction (valvuloplasty) and valve replacement with mechanical prostheses, biologic prostheses, or homograft (donor) valves. Reconstruction is used primarily for incompetent mitral and tricuspid valves and addresses each part of the valve apparatus individually. Annuloplasty rings are often used to restore the size and shape of the valve orifice. Long-term anticoagulation therapy is not necessary. The designs of mechanical prostheses have evolved since the early caged-ball prostheses. Current models are noted for their durability. Patients who undergo implantation of these prostheses must also undergo long-term anticoagulation therapy. Biologic prostheses made from porcine valves or bovine pericardium are not as durable as their mechanical counterparts, but they do not require long-term anticoagulation therapy. Homografts are used in relatively few centers. They have good hemodynamics and do not necessitate long-term anticoagulation therapy. Radiologists should be familiar with the radiographic appearance of the various valve prostheses and annuloplasty rings and with the advantages and disadvantages of their use in cardiac valvular surgery.
改善病变心脏瓣膜功能的手术方法包括瓣膜重建（瓣膜成形术）以及使用机械瓣膜、生物瓣膜或同种异体（供体）瓣膜进行瓣膜置换。重建主要用于二尖瓣和三尖瓣功能不全，且分别针对瓣膜装置的各个部分进行处理。瓣环成形环常被用于恢复瓣膜口的大小和形状。无需长期抗凝治疗。自早期笼球式瓣膜以来，机械瓣膜的设计不断发展。当前的型号以其耐用性著称。接受这些瓣膜植入的患者也必须接受长期抗凝治疗。由猪瓣膜或牛心包制成的生物瓣膜不如机械瓣膜耐用，但不需要长期抗凝治疗。同种异体瓣膜在相对较少的中心使用。它们具有良好的血流动力学，且无需长期抗凝治疗。放射科医生应熟悉各种瓣膜假体和瓣环成形环的影像学表现，以及它们在心脏瓣膜手术中使用的优缺点。
