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主动脉内球囊反搏治疗主动脉瓣关闭不全。实验研究。

Intra-aortic ballon pump for relief of aortic regurgitation. Experimental study.

作者信息

Moulopoulos S D, Anthopoulos L P, Antonatos P G, Adamopoulos P N, Nanas J N

出版信息

J Thorac Cardiovasc Surg. 1980 Jul;80(1):38-44.

PMID:7382533
Abstract

Backflow from the aorta to the left ventricle during diastole in aortic regurgitation can be reduced by expanding, during diastole, a small air balloon positioned in the ascending aorta downstream to the regurgitant valve. A spherical catheter-mounted balloon, acting as a prosthetic aortic valve for the correction of acute aortic regurgitation, was tested in 12 dogs. This "valve" was actively inflated and deflated by means of a common intra-aortic balloon pumping system (Datascope). A significant increase of end-diastolic pressure in the descending aorta, from 51.72 +/- 1.72 to 70.35 +/- 1.92 mm Hg (mean +/- standard error, p less than 0.001), was obtained, without a significant pressure gradient across the "valve". The "valve" prevented the backward flow of the descending aorta by up to 100%, so that there was a mean increase in t-e effective forward flow of 12.61 +/- 5.27% (mean +/- standard error, p less than 0.05). Coronary arterial flow changes varied during the application of the "valve." They depended directly on the changes of the diastolic component of the flow velocity wave, and this relationship was significant (x2 = 33.04, p less than 0.0001). Contractility indices were not significantly affected during the function of the "valve." It is suggested that the spherical "valve" mounted on a catheter may easily be inserted without thoracotomy for a temporary satisfactory correction of the aortic regurgitation.

摘要

在主动脉瓣关闭不全时,舒张期主动脉血液反流至左心室的情况可通过在舒张期扩张置于反流瓣膜下游升主动脉内的小气囊来减少。一种球形的导管式气囊,作为用于纠正急性主动脉瓣关闭不全的人工主动脉瓣,在12只犬身上进行了测试。这个“瓣膜”通过普通的主动脉内气囊泵系统(Datascope)进行主动充气和放气。降主动脉舒张末期压力显著升高,从51.72±1.72毫米汞柱升至70.35±1.92毫米汞柱(平均值±标准误差,p<0.001),且“瓣膜”两端无显著压力梯度。该“瓣膜”可使降主动脉的逆向血流减少达100%,有效前向血流平均增加12.61±5.27%(平均值±标准误差,p<0.05)。在应用该“瓣膜”过程中,冠状动脉血流变化各异。它们直接取决于流速波舒张成分的变化,且这种关系显著(x2 = 33.04,p<0.0001)。在“瓣膜”工作期间,心肌收缩力指标未受到显著影响。有人提出,安装在导管上的球形“瓣膜”可在不开胸的情况下轻松插入,以暂时令人满意地纠正主动脉瓣关闭不全。

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