CAJ | 학술논문

目的研制新型带瓣膜主动脉瓣支架（新型瓣膜支架），探讨其体外流体力学性能及耐久性。方法根据猪主动脉根部形状制作支架的磨具，采用镍钛合金丝和牛心包研制新型瓣膜支架，以瓣膜体外加速疲劳寿命测试仪对其进行体外加速疲劳实验（n＝5）。取5头中国实验用小型猪的离体升主动脉，通过连接体外流体力学性能测试系统，测试该新型瓣膜支架疲劳实验前后的流体力学参数（静态泄漏、瓣周漏、有效开口面积等），并进行对比研究。结果疲劳实验后新型瓣膜支架大体观察表现良好。该新型瓣膜支架在主动脉瓣上植入后均牢靠固定，无明显移位，均有轻度的静态泄漏和瓣周漏，在闭合定常流循环下流量为4 L/min时瓣口面积已大于1.5 cm2。疲劳实验前后对比各项参数整体比较变化不明显（ P＞0.05）。彩色多普勒超声心动图显示瓣中和瓣后流场基本保持层流。结论采用镍钛合金丝和牛心包研制的新型瓣膜支架耐久性良好，主动脉瓣上置入后均能牢靠固定，有轻度的静态泄漏和瓣周漏及较大的有效开口面积，瓣中和瓣后流场保持层流。
목적연제신형대판막주동맥판지가（신형판막지가），탐토기체외류체역학성능급내구성。방법근거저주동맥근부형상제작지가적마구，채용얼태합금사화우심포연제신형판막지가，이판막체외가속피로수명측시의대기진행체외가속피로실험（n＝5）。취5두중국실험용소형저적리체승주동맥，통과련접체외류체역학성능측시계통，측시해신형판막지가피로실험전후적류체역학삼수（정태설루、판주루、유효개구면적등），병진행대비연구。결과피로실험후신형판막지가대체관찰표현량호。해신형판막지가재주동맥판상식입후균뢰고고정，무명현이위，균유경도적정태설루화판주루，재폐합정상류순배하류량위4 L/min시판구면적이대우1.5 cm2。피로실험전후대비각항삼수정체비교변화불명현（ P＞0.05）。채색다보륵초성심동도현시판중화판후류장기본보지층류。결론채용얼태합금사화우심포연제적신형판막지가내구성량호，주동맥판상치입후균능뢰고고정，유경도적정태설루화판주루급교대적유효개구면적，판중화판후류장보지층류。
Objective To prepare new-style percutaneous aortic valved stent ( NPAVS) and to evaluate its hydrodynamic performance and durability in vitro.Methods According to anatomic parameter of aortic root of swine,the mold of NPAVS was manufactured .The stent was developed with self-expandable nitinol , then bovine pericardium was shaped and be sutured into stent .Five NPAVSs were tested against accelerated fatigue using artificial heart valve exosomatic accelerated fatigue instrument .Testing systems of in vitro hydrodynamic performance were developed .NPAVS were deployed above native leaflets .The hydrodynamic parameters ( the perivalvular leakage , regurgitation volume ,effective valvular orifice area and the characteristics of flow field ) of fore-and-after accelerated fatigue test of the five NPAVSs were obtained .Results General observations of the five NPAVSs after the fatigue test were fine.Five NPAVSs could be fast fixed in the ascending aorta .There were mild perivalvular leakage and regurgitation volume in steady pressure .At 4 L/min steady flow,the mean effective valvular orifice area was larger than 1.5 cm2 .The central and posterior flow pattern showed laminated flow .The hydrodynamic parameters of NPAVSs did not undergo significant changes after the fatigue test .Conclusions The NPAV has good durability ,be deployed above native leaflets in vitro,could be fast fixed .The perivalvular leakage and regurgitation volume are satisfactory .It has large effective valvular orifice area .The central and posterior flow pattern show laminated flow .