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主动脉瓣置换术中的连续缝合技术。

Continuous-suture technique in aortic valve replacement.

作者信息

Qicai He, Zili Chen, Zhengfu He, Weiming Zhang, Zhoumiao Chen, Dingsheng Ye, Bingtang Zhong

机构信息

Department of Cardiothoracic Surgery in Sir Run Run Shaw Hospital Zhejang University Medical School, Hangzhou, China.

出版信息

J Card Surg. 2006 Mar-Apr;21(2):178-81. doi: 10.1111/j.1540-8191.2006.00121.x.

Abstract

From April 2000 to April 2003 total 103 patients underwent aortic valve replacement and some concomitant cardiac procedures including mitral valve replacement in our hospital. According to the suture technique used in aortic valve replacement, the patients were divided into two groups: group A, 42 patients, the continuous suture technique with some modifications was used; group B, 61 patients, the conventional interrupted suture technique was used. There were no statistical differences between the two groups in age, sex, bodyweight, valve lesion, concomitant cardiac procedure and early mortality. But there were significant differences ([<0.001 approximately 0.012) in aortic cross-clamp time (AOCT) and cardiopulmonary bypass time (CPBT) between the two groups with less time for the group A patients. During a follow-up from 1 to 35 months, in group B, one patient developed perivalvular leak. The incidence of perivalvular leak was 1.7% (1/59). Three patients developed prosthetic bacterial endocarditis, the incidence of which was 5.0% (3/59). All the patients in group A recovered satisfactorily without suture technique or prosthesis associated complications. The modified technique was introduced and illustrated with diagrams, and the reasons for the advantages of the technique over the conventional interrupted suture technique were discussed.

摘要

2000年4月至2003年4月,我院共有103例患者接受了主动脉瓣置换术及一些同期心脏手术,包括二尖瓣置换术。根据主动脉瓣置换术中使用的缝合技术,将患者分为两组:A组42例,采用改良的连续缝合技术;B组61例,采用传统的间断缝合技术。两组在年龄、性别、体重、瓣膜病变、同期心脏手术及早期死亡率方面无统计学差异。但两组在主动脉阻断时间(AOCT)和体外循环时间(CPBT)上有显著差异(约为<0.001至0.012),A组患者的时间较短。在1至35个月的随访期间,B组有1例患者发生瓣周漏。瓣周漏发生率为1.7%(1/59)。3例患者发生人工瓣膜心内膜炎,发生率为5.0%(3/59)。A组所有患者恢复良好,无缝合技术或人工瓣膜相关并发症。介绍了改良技术并配以示意图,并讨论了该技术优于传统间断缝合技术的原因。

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