Montorsi P, Cavoretto D, Repossini A, Bartorelli A L, Guazzi M D
Istituto di Cardiologia dell'Università degli Studi, Centro Cardiologico Fondazione Monzino, IRCCS, Milan, Italy.
Am J Card Imaging. 1996 Jan;10(1):29-41.
Bileaflet prostheses are low profile, central flow orifice devices that show excellent hemodynamic performance and low thrombogenicity. Five models are currently used for heart valve replacement. Comprehensive and comparative studies regarding valve characteristics and functioning are lacking, making the updating and the familiarization by physicians and cardiologists with these prostheses difficult. We describe the valve design characteristics and evaluate the cine-fluoroscopic appearance and functioning of 387 bileaflet prostheses that have been implanted in 367 consecutive patients. The valve types are St Jude Medical (n = 69), Edwards-Duromedics (n = 74), Carbomedics (n = 1290) Sorin Bicarbon (n = 88) and Jyros (n = 27). The prostheses' fluoroscopic appearance was evaluated through multiple radiographic views (Siemens-Elema equipment with C-arm); the prostheses' functional evaluation was performed by obtaining the "tilting disk projection" (ie, with the radiographic beam parallel to both the valve ring plane and the tilting axis of disks) to calculate opening, closing, and travel angles of the disks. This study shows that each of the five bileaflet valves has distinctive design characteristics. Fluoroscopy is an easy, readily available, and useful technique that correctly identifies the prosthesis type and properly evaluates its functioning in the majority of cases.
双叶瓣人工心脏瓣膜是低剖面、中心血流孔口装置，具有出色的血流动力学性能和低血栓形成性。目前有五种型号用于心脏瓣膜置换。缺乏关于瓣膜特性和功能的全面比较研究，使得医生和心脏病专家对这些人工心脏瓣膜的更新和熟悉变得困难。我们描述了瓣膜设计特征，并评估了连续367例患者植入的387个双叶瓣人工心脏瓣膜的荧光透视外观和功能。瓣膜类型有圣犹达医疗公司（St Jude Medical）的（n = 69个）、爱德华兹-杜罗梅迪克斯（Edwards-Duromedics）的（n = 74个）、卡波梅迪克斯（Carbomedics）的（n = 129个）、索林碳酸氢盐（Sorin Bicarbon）的（n = 88个）和吉罗斯（Jyros）的（n = 27个）。通过多个放射学视图（配备C型臂的西门子-埃莱玛设备）评估人工心脏瓣膜的荧光透视外观；通过获得“倾斜盘投影”（即放射线束与瓣膜环平面和盘的倾斜轴平行）来计算盘的打开、关闭和行程角度，从而对人工心脏瓣膜进行功能评估。本研究表明，五种双叶瓣瓣膜中的每一种都有独特的设计特征。荧光透视是一种简单、易于获得且有用的技术，在大多数情况下能正确识别人工心脏瓣膜的类型并恰当评估其功能。
