| 摘要: |
| 目的 探讨重度主动脉瓣狭窄患者行瓣膜置换术后左室流出道流速增快的发生机制及其相关因素。方法 选取76例重度主动脉瓣狭窄患者，分为联合瓣膜病组与单纯性主动脉瓣狭窄组，并把单纯性主动脉瓣狭窄组分成两组(I组：术后LVOT流速增加；II组：术后LVOT流速未见明显增加)。术前记录患者左室舒张末期内径、室间隔厚度、是否合并主动脉瓣畸形、LVOT流速、左室射血分数等，并在术后常规随访超声心动图。结果 26例联合瓣膜病组患者行AVR后，2例发生LVOT流速增加，50例单纯性AS患者中则有18例出现此现象；对于单纯性主动脉瓣狭窄患者，两组患者之间LVEDD、室间隔厚度与LVEDD比值有统计学差异。对于单纯性AS术后左室流速增加的18例患者，术后1周内流速增加最快，6个月左右流速大都能恢复正常。结论 主动脉瓣狭窄患者行瓣膜置换术后左室流出道流速增快发生率较高，流速变化呈现先增加后降低的趋势，大多数术后6个月左右回复正常；多发生于术前为单纯性主动脉瓣狭窄的患者；并且与左室舒张末期内径大小、室间隔厚度与左室舒张末期内径比值相关，与术前主动脉瓣跨瓣压差、是否畸形、术后假体瓣膜性质等无关。 |
| 关键词: 主动脉瓣狭窄 主动脉瓣置换 超声心动图 左室流出道流速 |
| DOI： |
| 投稿时间：2016-06-12修订日期：2016-06-28 |
| 基金项目: |
|
| Velocity variation and influence factor analysis of LVOT after AVR for severe AS |
| Zhangli |
| (Department of Cardiothoracic Surgery, Xinhua hospital Affiliated to Shanghai Jiao Tong University Medical School) |
| Abstract: |
| Objective To explore the mechanism and related factors of LVOT Velocity speed after AVR for severe AS. Methods 76 patients after AVR for severe AS were enrolled in this study. Divided into combined valvular disease group and pure AS group. And then divided the pure AS group into another two groups (I: Velocity of LVOT speed up; II: Velocity of LVOT is not speed up). Preoperative record LVEDD、thickness of IVS、whether combined aortic malformation、Velocity of LVOT、EF of LV and follow-up Echocardiography Postoperative. Results 2 of 26 patients’ LVOT Velocity speed up after AVR with combined valvular disease, 18 of 50 patients’ LVOT Velocity speed up after AVR with pure AS disease. For pure AS, there are statistically significant difference between the two groups of the LVEDD and the ratio between IVS thickness and LVEDD. For 18 patients whose LVOT Velocity speed up after AVR with pure AS disease, the velocity increases quickest in 1week post-operation and be back to normal about 6 months. Conclusion The incidence of LVOT Velocity speed up after AVR for severe AS is high.
Velocity is increasing first and then decreasing. It will be back to normal about 6 months. Mostly are pure AS patients pre-operation. Related to LVEDD and the ratio between IVS thickness and LVEDD. |
| Key words: aortic stenosis aortic valve replacement Echocardiography LVOT Velocity |
