中国组织工程研究
中國組織工程研究
중국조직공정연구
Journal of Clinical Rehabilitative Tissue Engineering Research
2013年
44期
7667-7674
,共8页
器官移植%心肺移植%主动脉瓣%生物瓣膜%心血管%无支架%植入方法%体外测试
器官移植%心肺移植%主動脈瓣%生物瓣膜%心血管%無支架%植入方法%體外測試
기관이식%심폐이식%주동맥판%생물판막%심혈관%무지가%식입방법%체외측시
heart valve prosthesis implantation%stents%aortic valve%heart valves%thromboembolism%cardiac output
背景：现有的生物瓣膜主要分为有支架和无支架两种。有支架瓣膜方便了手术操作，容易植入，植入后发生关闭不全的可能性小，但这种瓣膜并没有很好的模拟天然瓣膜。目的：为缩短瓣膜植入时间，进一步改善瓣膜性能，在参考猪主动脉根构型优化瓣膜设计的基础上，开发一种新型的适合单层缝合置入的无支架猪主动脉瓣膜，体外测试评估其性能。方法：①制备适合单层缝合的无支架猪主动脉瓣。②采用自行设计的新型单层缝合方法进行离体瓣膜植入实验。③对新型瓣膜进行体外流体力学测试及疲劳测试。结果与结论：适合单层缝合的无支架瓣膜在设计中去除了硬质的瓣架，可减轻血流冲击对瓣叶的损害，同时去除硬质瓣环后手术时可以植入口径更大的瓣膜，改善了血流动力学，较传统双层缝合瓣膜缩短了植入时间。经体外流体力学测试及疲劳测试，结果满意。但无支架生物瓣膜植入手术操作时间长、术后长期临床效果及耐久性尚需进一步临床结果验证。
揹景：現有的生物瓣膜主要分為有支架和無支架兩種。有支架瓣膜方便瞭手術操作，容易植入，植入後髮生關閉不全的可能性小，但這種瓣膜併沒有很好的模擬天然瓣膜。目的：為縮短瓣膜植入時間，進一步改善瓣膜性能，在參攷豬主動脈根構型優化瓣膜設計的基礎上，開髮一種新型的適閤單層縫閤置入的無支架豬主動脈瓣膜，體外測試評估其性能。方法：①製備適閤單層縫閤的無支架豬主動脈瓣。②採用自行設計的新型單層縫閤方法進行離體瓣膜植入實驗。③對新型瓣膜進行體外流體力學測試及疲勞測試。結果與結論：適閤單層縫閤的無支架瓣膜在設計中去除瞭硬質的瓣架，可減輕血流遲擊對瓣葉的損害，同時去除硬質瓣環後手術時可以植入口徑更大的瓣膜，改善瞭血流動力學，較傳統雙層縫閤瓣膜縮短瞭植入時間。經體外流體力學測試及疲勞測試，結果滿意。但無支架生物瓣膜植入手術操作時間長、術後長期臨床效果及耐久性尚需進一步臨床結果驗證。
배경：현유적생물판막주요분위유지가화무지가량충。유지가판막방편료수술조작，용역식입，식입후발생관폐불전적가능성소，단저충판막병몰유흔호적모의천연판막。목적：위축단판막식입시간，진일보개선판막성능，재삼고저주동맥근구형우화판막설계적기출상，개발일충신형적괄합단층봉합치입적무지가저주동맥판막，체외측시평고기성능。방법：①제비괄합단층봉합적무지가저주동맥판。②채용자행설계적신형단층봉합방법진행리체판막식입실험。③대신형판막진행체외류체역학측시급피로측시。결과여결론：괄합단층봉합적무지가판막재설계중거제료경질적판가，가감경혈류충격대판협적손해，동시거제경질판배후수술시가이식입구경경대적판막，개선료혈류동역학，교전통쌍층봉합판막축단료식입시간。경체외류체역학측시급피로측시，결과만의。단무지가생물판막식입수술조작시간장、술후장기림상효과급내구성상수진일보림상결과험증。
BACKGROUND:The artificial heart valve used in clinical application can be divided into stented and stentless. Stented valve is convenient for operations, with a low possibility of incompetency after transplantation. However stented valve cannot stimulate natural valve. OBJECTIVE:To reduce valve implantation time and improve valve properties, this study was designed to develop a new stentless porcine aortic valve for single-layer suture and implantation based on the design of valve in pig aortic root geometry optimization, and to further evaluate its performance by in vitro test. METHODS:(1) Stentless porcine aortic valve for single-layer suture was prepared. (2) The in vitro valve implantation experiment was performed with monolayer suture method. (3) The valve was detected by in vitro fluid mechanics test and fatigue test. RESULTS AND CONCLUSION:Stentless valve for single-layer suture has removed the valve hard, which contributes to reduce the damaged caused by blood flow on the valve leaflet, at the same time removal of the hard valve ring can widen the diameter of implanted valve and improve hemodynamics, even the implantation time of valve is shorter than traditional double-layer suture. The in vitro fluid mechanics test and fatigue test results are satisfactory. The future research lies in a complete elucidation of long operation time, postoperative long-term clinical efficacy and durability of stentless valve implantation.
