Imanaka K, Yagyu K, Ono M, Takeshita M, Kotsuka Y, Furuse A
Department of Cardiothoracic Surgery, University of Tokyo School of Medicine, Japan.
Kyobu Geka. 1997 Sep;50(10):829-34.
Cardiac function after aortic valve replacement for chronic aortic regurgitation with CarboMedics heart valve was evaluated repeatedly by echocardiography and some examinations in 27 cases. There was no late death and all patients belonged to NYHA I functional class postoperatively. Systolic and diastolic dimensions of left ventricle, left ventricular mass index, cardiothoracic ratio and SV1+RV5 on electrocardiography improved significantly within half a year and those improved results remained thereafter. Fractional shortening of left ventricle also improved gradually and the difference reached statistical significance one year later. This investigation revealed reduced systolic function or eccentric myocardial hypertrophy were often reversible. Average values of systolic diameter and fractional shortening late after operation were within normal range even in cases whose preoperative systolic function were severely depressed. Left ventricular mass index decreased markedly although postoperative values were still out of normal range in most cases. These results suggest that aortic valve replacement can be indicated even in cases of aortic regurgitation with severely impaired preoperative cardiac function.
对27例使用CarboMedics心脏瓣膜进行慢性主动脉瓣反流主动脉瓣置换术后的心脏功能,通过超声心动图及一些检查进行了反复评估。无晚期死亡病例,所有患者术后均属于纽约心脏协会(NYHA)心功能I级。左心室的收缩和舒张径、左心室质量指数、心胸比率以及心电图上的SV1+RV5在半年内显著改善,且此后这些改善结果持续存在。左心室缩短分数也逐渐改善,1年后差异具有统计学意义。该研究表明,收缩功能降低或离心性心肌肥厚通常是可逆的。即使术前收缩功能严重降低的病例,术后晚期收缩径和缩短分数的平均值也在正常范围内。左心室质量指数明显下降,尽管大多数病例术后值仍超出正常范围。这些结果表明,即使术前心功能严重受损的主动脉瓣反流病例,也可考虑行主动脉瓣置换术。