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圣犹达医疗公司瓣膜假体的超声心动图特征(作者译)

[Echocardiographic features of the St. Jude Medical valve prosthesis (author's transl)].

作者信息

Antoniucci D, Paolini G, Salvatore L, Zerauschek M

出版信息

G Ital Cardiol. 1981;11(12):2039-47.

PMID:7346304
Abstract

The St. Jude Medical (SJM) valve is a new low-profile bileaflet prosthesis with central flow, low transvalvular gradients and low thrombogenicity. Echocardiographic features of 212 correctly functioning SJM prostheses implanted in 160 patients were studied. A SJM prosthesis echogram is unique for the presence of echoes from two hemidisks that come together when the valve opens and separate when the valves close. The movement of the two hemidisks is not always synchronous. A little asynchronism (less than 0.01 sec.) is possible as the valve begins to open. More pronounced asynchronisms are recorded in prostheses implanted in mitral position and specially when the R-R interval is longer than 1 sec. In this case partial or definitive mid-diastolic closure of the posterior hemidisk is frequent. On the contrary the anterior hemidisk always remains in maximum open position for the complete duration of the diastole. Opening and closing velocities of the valve are extremely variable. However, opening velocity, independent of where the prosthesis is implanted, is always slower than the closing one. The opening valve interval is 0.06-0.10 sec. in mitral position and 0.03-0.05 sec. in aortic position. Echocardiography is a very useful diagnostic tool for evaluating the efficiency of SJM prosthesis. Data obtained from echograms of prostheses implanted in mitral position prove that the inertia of the valve hemidisks is similar to that of natural valve leaflets.

摘要

圣犹达医疗(SJM)瓣膜是一种新型的低轮廓双叶人工瓣膜,具有中心血流、低跨瓣压差和低血栓形成性。对植入160例患者体内的212个功能正常的SJM人工瓣膜的超声心动图特征进行了研究。SJM人工瓣膜的超声心动图有其独特之处,即当瓣膜打开时,两个半圆盘产生的回声会汇聚在一起,而当瓣膜关闭时则会分开。两个半圆盘的运动并不总是同步的。瓣膜开始打开时可能会有轻微的不同步(小于0.01秒)。在二尖瓣位植入的人工瓣膜中记录到更明显的不同步情况,特别是当R-R间期超过1秒时。在这种情况下,后半圆盘在舒张中期部分或完全关闭的情况很常见。相反,前半圆盘在整个舒张期始终保持在最大开放位置。瓣膜的打开和关闭速度变化极大。然而,无论人工瓣膜植入何处,打开速度总是比关闭速度慢。二尖瓣位的瓣膜打开间期为0.06 - 0.10秒,主动脉位为0.03 - 0.05秒。超声心动图是评估SJM人工瓣膜效能的非常有用的诊断工具。从二尖瓣位植入人工瓣膜的超声心动图获得的数据证明,瓣膜半圆盘的惯性与天然瓣膜小叶的惯性相似。

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