Sigwart U, Schmidt H, Gleichmann U, Borst H G
Ann Thorac Surg. 1976 Sep;22(3):213-20. doi: 10.1016/s0003-4975(10)64905-3.
In vivo evaluation of the Lillehei-Kaster heart valve prosthesis was performed in 28 patients; 22 had undergone aortic valve replacement and 6 had had mitral valve replacement. Mean pressure gradients ranged from 6 to 53 mm Hg in aortic prostheses; valve area varied from 0.83 to 2.9 cm2. The maximum opening angle of 80 degrees was never reached in this group of patients; opening angles ranged from 57 to 74 degrees without evidence of disc malfunction. There was no correlation between the ratio of effective to geometric valve area and the degree of opening of the disc occluder. Similar results were found in the mitral valve group. Gradients ranged from 6.0 to 12.5 mm Hg and valve area from 1.6 to 2.2 cm2. The maximum opening angle was 59 to 63 degrees. It is concluded that incomplete opening of the disc occluder in pivoting-disc valves is not necessarily a sign of disc malfunction. Lillehei-Kaster valves smaller than 18 mm in internal diameter should be avoided in adults, and outflow aortoplasty for implantation of a larger prosthesis should be used in patients who have a narrow aortic root.
对28例患者进行了Lillehei-Kaster心脏瓣膜假体的体内评估；其中22例接受了主动脉瓣置换，6例接受了二尖瓣置换。主动脉假体的平均压力梯度在6至53 mmHg之间；瓣膜面积在0.83至2.9 cm²之间。该组患者从未达到80度的最大开口角度；开口角度在57至74度之间，未发现瓣膜盘故障迹象。有效瓣膜面积与几何瓣膜面积之比与瓣膜盘封堵器的开口程度之间无相关性。二尖瓣组也发现了类似结果。压力梯度在6.0至12.5 mmHg之间，瓣膜面积在1.6至2.2 cm²之间。最大开口角度为59至63度。得出的结论是，枢轴式瓣膜盘封堵器开口不完全不一定是瓣膜盘故障的迹象。成人应避免使用内径小于18 mm的Lillehei-Kaster瓣膜，对于主动脉根部狭窄的患者，应采用流出道主动脉成形术以植入更大的假体。
