Katsumata T, Nemoto S, Endo M, Hashimoto A, Koyanagi H, Kurosawa H
Department of Cardiovascular Surgery, Heart Institute of Japan, Tokyo Women's Medical College.
Kyobu Geka. 1995 May;48(5):381-4.
Newly-developed procedure for aortic annular enlargement was geometrically examined on its optimal annular augmentation. Valve prosthesis is accommodated by anterior annular split extending into aortopulmonary and infundibular septum and, eventually, protrudes into pulmonary valvular orifice in this procedure. Relationship between residual pulmonary valvular area (PVA) and aortic annular incremental radius (x) is given by: PVA = (r+x)2 [pi - 2 pi x/(r+x) + sin (2 pi x/(r+x))], where r is original aortic annular radius. Optimal aortic annular augmentation maximizing PVA and saving original PVA is 1.33 times and 1.70 times of original diameter respectively. Animal experiments employing six mongrel dogs demonstrated no significant increase of systolic peak pressure gradient in right ventricular outflow tract after the procedure standardized by this geometrical idea. Our procedure would bear radical enlargement of small aortic annulus.
对新开发的主动脉瓣环扩大手术进行了几何学检查，以确定其最佳的瓣环增大效果。在该手术中，瓣膜假体通过延伸至主动脉肺动脉和漏斗间隔的前瓣环裂开进行安置，并最终突入肺动脉瓣口。残余肺动脉瓣面积（PVA）与主动脉瓣环增量半径（x）之间的关系为：PVA = (r+x)2 [π - 2πx/(r+x) + sin (2πx/(r+x))]，其中r为原始主动脉瓣环半径。使PVA最大化并保留原始PVA的最佳主动脉瓣环增大值分别为原始直径的1.33倍和1.70倍。采用6只杂种犬进行的动物实验表明，按照这种几何学理念进行标准化手术后，右心室流出道的收缩期峰值压力梯度没有显著增加。我们的手术将能够对小主动脉瓣环进行根治性扩大。
