Tandon A P, Smith D R, Whitaker W, Ionescu M I
Br Heart J. 1978 Jun;40(6):602-7. doi: 10.1136/hrt.40.6.602.
Haemodynamic studies were performed in 30 patients at a mean interval of 43.4 (range 27 to 59) months after aortic valve replacements with pericardial xenografts. Five valve sizes--19, 21, 23, 25, and 27 mm annulus diameter--were used. Of these 30 patients, 16 had preoperative haemodynamic investigations. Comparison of the pre- and postoperative data showed a marginal but significant increase in cardiac output (P less than 0.05). There was a significant reduction in the pulmonary wedge and left ventricular end-diastolic pressures at rest and on exercise (P less than 0.05 and P less than 0.01). At the postoperative study the mean peak systolic gradient was 8.3 mmHg at rest and 12.3 mmHg on exercise in patients with the smallest xenograft inserted (19 mm) and decreased with each corresponding increase in graft size, so that across the 27 mm graft it was hardly measurable. The calculated xenograft surface area ranged from 1.1 to 2.1 cm2 at rest and 1.3 to 2.4 cm2 during exercise. Aortic root angiography showed competent valves in all 30 patients, but a grade 1 to 2 perivalvular leak was shown in 8 patients. This long-term study has indicated significant circulatory improvement and very small transvalvular gradients in patients with aortic pericardial xenografts.
对30例使用心包异种移植物进行主动脉瓣置换术的患者进行了血流动力学研究，平均间隔时间为43.4个月（范围为27至59个月）。使用了五种瓣膜尺寸——瓣环直径分别为19、21、23、25和27毫米。在这30例患者中，16例术前进行了血流动力学检查。术前和术后数据比较显示心输出量有轻微但显著增加（P<0.05）。静息和运动时肺楔压和左心室舒张末期压力均显著降低（P<0.05和P<0.01）。在术后研究中，植入最小异种移植物（19毫米）的患者静息时平均收缩期峰值压差为8.3毫米汞柱，运动时为12.3毫米汞柱，并且随着移植物尺寸相应增加而降低，因此在27毫米移植物中几乎无法测量。计算得出的异种移植物静息时表面积范围为1.1至2.1平方厘米，运动时为1.3至2.4平方厘米。主动脉根部血管造影显示所有30例患者瓣膜功能良好，但8例患者存在1至2级瓣周漏。这项长期研究表明，使用主动脉心包异种移植物的患者循环有显著改善，跨瓣压差非常小。
