Badiu Catalin Constantin, Deutsch Marcus-Andre, Bleiziffer Sabine, Krane Markus, Hettich Ina, Voss Bernhard, Mazzitelli Domenico, Lange Rüdiger
J Heart Valve Dis. 2014 Jan;23(1):97-104.
The study aim was to examine the hemodynamic performance of the BioValsalva porcine aortic valve conduit in the aortic root position.
Between February 2007 and April 2012, a total of 223 patients underwent aortic root replacement at the authors' institution. The BioValsalva valved conduit was implanted in 131 patients, and 86 of these patients (mean age 64.7 +/- 9.7 years) consented to participate in the present study. The parameters assessed to evaluate prosthetic valve function included mean pressure gradient (MPG) as measured by transthoracic Doppler echocardiography, and the effective orifice area (EOA) by means of the continuity equation. Hemodynamic data were obtained from all 86 patients within 10 days and six months postoperatively.
The mean aortic cross-clamp time was 103 +/- 30 min. Concomitant procedures were performed in 50 patients (56.5%). Four patients developed valve dysfunction due to endocarditis, and underwent a reoperation without the need to perform a redo Bentall. The early MPG across the implanted valve was 12 +/- 4.6 mmHg (range: 4-24.8 mmHg), and the early mean EOA was 1.81 +/- 0.6 cm2 (range: 0.9-3.2 cm2). After six months the MPG was 11.6 +/- 4.6 mmHg (range: 2.2-25.5 mmHg) and the EOA was 1.69 +/- 0.43 cm2 (range: 0.8-2.6 cm2).
Based on its special design with a stentless valve, which is not incorporated into the proximal suture line, the BioValsalva conduit has an advantage over intraoperatively prepared conduits in cases of reoperation. Besides simplified intraoperative handling, the BioValsalva conduit exhibits good systolic hemodynamic performance with large EOAs.
本研究旨在检测BioValsalva猪主动脉瓣管道在主动脉根部位置的血流动力学性能。
2007年2月至2012年4月期间，共有223例患者在作者所在机构接受了主动脉根部置换术。131例患者植入了BioValsalva带瓣管道，其中86例患者（平均年龄64.7±9.7岁）同意参与本研究。评估人工瓣膜功能的参数包括经胸多普勒超声心动图测量的平均压力阶差（MPG）以及通过连续性方程计算的有效瓣口面积（EOA）。在术后10天内及术后6个月从所有86例患者获取血流动力学数据。
平均主动脉阻断时间为103±30分钟。50例患者（56.5%）进行了同期手术。4例患者因心内膜炎出现瓣膜功能障碍，接受了再次手术，无需进行再次Bentall手术。植入瓣膜的早期MPG为12±4.6 mmHg（范围：4 - 24.8 mmHg），早期平均EOA为1.81±0.6 cm²（范围：0.9 - 3.2 cm²）。6个月后，MPG为11.6±4.6 mmHg（范围：2.2 - 25.5 mmHg），EOA为1.69±0.43 cm²（范围：0.8 - 2.6 cm²）。
基于其无支架瓣膜的特殊设计（未纳入近端缝线处），BioValsalva管道在再次手术时比术中制备的管道具有优势。除了简化术中操作外，BioValsalva管道还具有良好的收缩期血流动力学性能以及较大的EOA。
