Shibata Toshihiko, Inoue Kazushige, Ikuta Takeshi, Bito Yasuyuki, Yoshioka Yoshiteru, Mizoguchi Hiroki
Department of Cardiovascular Surgery, Osaka City General Hospital, Miyakojima, Osaka, Japan.
Interact Cardiovasc Thorac Surg. 2009 Feb;8(2):206-10. doi: 10.1510/icvts.2008.187666. Epub 2008 Nov 14.
The valve-on-valve (VOV) technique is that a mechanical valve is implanted on the sewing cuff of the previous bioprosthesis after removing degenerated leaflets. We conducted an in vitro study to determine the size-match of the valves for VOV technique. The Carpentier-Edwards pericardial (CEP) valve and Mosaic valve were used. We measured the inner diameter of the bioprosthesis after removing the leaflets. We investigated five mechanical mitral valves and two mechanical aortic valves (inverted use). The mitral valves used in this study were the ATS valve (ATS), the CarboMedics standard valve (CMS), the CarboMedics OptiForm valve (CMO), the On-X valve, and the St Jude valve (SJM). Two aortic mechanical valves, CarboMedics and St Jude Regent valves, were investigated for inverted use. After removing the tissue leaflets, the inner diameter of the Mosaic valve was 3 mm smaller than that of the CEP valve even in the same catalogue labeling size. The outer diameters of the housing of the ATS, CMS, CMO, On-X, and SJM valves of the same catalogue size (25 mm) were 25.7, 25.8, 22.0, 25.0, and 23.2 mm, respectively. SJM and CMO valves are the favorite mechanical valve for the VOV technique in terms of the profile and size-match.
瓣中瓣（VOV）技术是指在去除退化瓣叶后，将机械瓣膜植入先前生物瓣膜的缝合袖口处。我们进行了一项体外研究，以确定用于VOV技术的瓣膜尺寸匹配情况。使用了Carpentier-Edwards心包（CEP）瓣膜和Mosaic瓣膜。我们测量了去除瓣叶后生物瓣膜的内径。我们研究了五个机械二尖瓣和两个机械主动脉瓣（倒置使用）。本研究中使用的二尖瓣为ATS瓣膜（ATS）、CarboMedics标准瓣膜（CMS）、CarboMedics OptiForm瓣膜（CMO）、On-X瓣膜和圣犹达瓣膜（SJM）。研究了两个主动脉机械瓣膜CarboMedics和圣犹达Regent瓣膜的倒置使用情况。去除组织瓣叶后，即使在相同的目录标注尺寸下，Mosaic瓣膜的内径也比CEP瓣膜小3mm。相同目录尺寸（25mm）的ATS、CMS、CMO、On-X和SJM瓣膜的外壳外径分别为25.7、25.8、22.0、25.0和23.2mm。就外形和尺寸匹配而言，SJM和CMO瓣膜是VOV技术最适合的机械瓣膜。
