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find Keyword "心脏瓣膜" 137 results
  • 应用聚乳酸聚乙醇酸膜构建组织工程心脏瓣膜的实验研究

    目的 探讨应用聚乳酸聚乙醇酸(PLGA)构建组织工程心脏瓣膜的可行性. 方法 扫描电子显微镜观察PLGA结构特点,将PLGA在兔皮下包埋,分别于2周、4周、6周、8周和12周观察材料的生物相容性和降解率,培养犬主动脉瓣间质细胞、主动脉壁间质细胞和皮肤成纤维细胞,对照其生长曲线、平滑肌α肌动蛋白表达和扫描电子显微镜特点.将犬主动脉壁间质细胞和内皮细胞种植于PLGA上,观察其形态并测定细胞合成胶原和前列环素的功能. 结果 PLGA呈网孔状结构,孔径179μm.皮下包埋显示PLGA生物相容性好,体内降解时间为12周.犬主动脉瓣间质细胞和主动脉壁间质细胞平滑肌α肌动蛋白均为部分阳性表达,细胞内有大量粗面内质网,生长曲线相似.细胞种植显示细胞在材料表面生长良好,并具有合成胶原和前列环素的功能(P<0.05 ). 结论 以PLGA为支架体外构建组织工程心脏瓣膜细胞不仅能在PLGA表面生长,还能合成细胞间质和血管活性物质,初步提示应用本组材料和方法构建组织工程心脏瓣膜是可行的.

    Release date:2016-08-30 06:34 Export PDF Favorites Scan
  • Application of Del Nido cardioplegia in adult valve surgery: A case control study

    Objective To investigate the myocardial protective effects of Del Nido cardioplegia and analyze its advantages in adult cardiac surgery. Methods We retrospectively analyzed the clinical data of 96 adult patients undergoing cardiac valve surgery who received Del Nido cardioplegia (a DNC group) from June 2016 to January 2017 in our hospital. There were 44 males and 52 females with a mean age of 51.36±13.31 years. Meanwhile 96 patients who received conventional cardioplegia were recruited as a control group (a CTC group) and there were 53 males and 43 females with a mean age of 52.91±10.95 years. Cross-clamping time, cardiopulmonary bypass (CPB) time, total volume of and transfusion frequency of cardioplegia, the rate of spontaneous defibrillation, red blood cell transfusion and vasoactive-inotropic score at postoperative 24 hours (VIS 24) were recorded. Results No significant difference was found in age, body weight, ejection fraction, hematokrit, CPB time and cross-clamping time between the DNC group and CTC group. There was no significant difference in the rate of spontaneous defibrillation, VIS 24, cardiac enzymes and cardiactroponin I and length of ICU stay between the two groups. The total volume and transfusion frequency of cardioplegia, perioperative blood transfusion were lower in the DNC group. There was no new atrial fibrillation or in-hospital death in the two groups. Conclusion Del Nido is a good myocardial protection solution in adult cardiac valve surgery, and requires less static preload volume and reduceshemodilution and perioperative blood transfusion.

    Release date:2018-08-28 02:21 Export PDF Favorites Scan
  • Echocardiography Expression in Heart Valve Damage with Rheumatoid Arthritis

    【摘要】随着超声心动图的普及与发展,无症状性类风湿性关节炎心脏瓣膜改变的检出率逐渐增多。临床应重视类风湿性关节炎心脏瓣膜损害以及超声心动图在这类疾病中的诊断价值,以期改善患者预后。【Abstract】 Objective More and more cardiac valve changes are detected in asymptomatic patients with rheumatoid arthritis by echocardiography. It is essential to pay attention to the clinical features of heart valves damage and the diagnostic value of echocardiography on that in order to improve the prognosis of patients.

    Release date:2016-09-08 09:45 Export PDF Favorites Scan
  • 三尖瓣前叶血性囊肿一例

    Release date:2016-10-02 04:56 Export PDF Favorites Scan
  • Advances in diagnosis and surgical treatment of infective endocarditis

    Infective endocarditis (IE) is a disease with severe complications and high mortality. It is heterogeneous in etiology, clinical manifestations, and course. At the same time, there are many disputes on the clinical practice of antibiotic treatment, surgical indications and timing. In this review, we discuss the epidemiology, diagnosis, treatment, and prevention of IE, especially the latest advances in surgical treatment after the release of European Society of Cardiology and American Heart Association guidelines in 2015.

    Release date:2021-07-02 05:22 Export PDF Favorites Scan
  • Surgical Treatment for Prosthetic Valve Endocarditis after Valve Replacement

    Abstract:Objective To investigate the reoperation indication,surgical timing and the key point of surgical treatment of prosthetic valve endocarditis (PVE) after valve replacement. Methods From February 2000 to July 2005,18 patients with PVE underwent surgery ,their clinical manifestation ,process of treatment and their prognosis outcome were analyzed. Results There were 3 patients (16.7 %) of early-death, 1 patient died of septic shock, and 2 patients died of multiple organ failure. Since 2003,there was no operative death for all 11 patients. There were 6 patients with respiratory insufficiency, 2 patients with renal insufficiency,which were recovered after treatment. The 15 survivors were followed up from 1 month to 5years. There was recurrence of infection in 1 patient who died after ineffective medical treatment. The other 14 patients recovered well. Conclusion It has high risk and high mortality for reoperation for PVE. Accurate reoperative indication,optimal surgical timing,radical debridment of infected tissue and correct perioperative use of antibiotics are the key factors to improve the reoperative result for PVE.

    Release date:2016-08-30 06:23 Export PDF Favorites Scan
  • Effect of pulmonary hypertension on clinical efficacy of Cox Maze Ⅳ procedure in treating atrial fibrillation patients with valvular heart disease: A retrospective cohort study

    ObjectiveTo explore the effect of pulmonary hypertension on the clinical efficacy of Cox Maze Ⅳ procedure in treating atrial fibrillation (AF) patients with valvular heart disease.MethodsThe clinical data of 84 patients who received cardiac valve replacement and Cox Maze Ⅳ ablation in our hospital from July 2017 to January 2020 were retrospectively analyzed. According to the estimation of pulmonary artery pressure (PAP) by ultrasound, the patients were divided into two groups: a group A (PAP<45 mm Hg, 20 males, 26 females with an average age of 59.1±7.8 years) and a group B (PAP≥45 mm Hg, 15 males and 23 females with an average age of 58.5±8.5 years). The PAP was less than 70 mm Hgin all patients. A systematic follow-up review was performed for 6 months after operation. The recovery and recurrence rate of sinus rhythm after surgical ablation were compared between the two groups, and the efficacy was analyzed.Results(1) All the patients completed the operation successfully, and there was no statistical difference in the ablation time between the two groups (P>0.05); no patients died of pulmonary infection after the operation, and one patient underwent implantation of a permanent pacemaker due to conduction block. (2) At the end of the operation and 3 months after the operation, the conversion rate of AF in the group A was 91.3% (42 patients) and 82.6% (38 patients), respectively, and in the group B was 89.5% (34 patients) and 73.7% (28 patients), respectively (P>0.05). The conversion rate of AF was 82.6% (38 patients) in the group A and 63.2% (24 patients) in the group B at 6 months after operation (P=0.043). Binary logistic regression analysis showed that PAP≥45 mm Hg had a significant effect on the long-term effect of surgical Maze procedure in treating AF patients with valvular heart disease [P=0.014, OR=5.661, 95%CI (1.429, 22.432)].ConclusionPAP may be an influencing factor for the long-term effect of surgical Maze procedure in treating AF patients with valvular heart disease. Although the long-term recurrence rate of AF in the moderate pulmonary hypertension group is higher than that in the group A, the overall effect is still safe and effective; therefore it is still worth promoting in clinical application.

    Release date:2021-12-27 11:31 Export PDF Favorites Scan
  • Primary Study of Tissue-engineered Heart Valve Reconstructed on Acellularized Porcine Aortic Valve and Rabbit Bone Marrow Stromal Cells

    Objective To explore the feasibility of tissue-engineered heart valve (TEHV) reconstructed on acellularized porcine aortic valve and rabbit bone marrow stromal cells (BMSCs) in vitro. Methods Acellularized was performed in porcine aortic valve by the detergent and enzymatic extraction process . Morphological and biomechanical properties were compared between the decellularized scaffolds and the fresh valves. Rabbit BMSCs were seeded on the scaffolds. The TEHV were analyzed by light microscopy, electron microscopy and immunohistochemistry. Results Almost complete removal of the cellular components and soluble protein of valves were observed , while the construction of matrix was properly maintained. Biomechanical tests demonstrated no statistically significant change in the breaking intensity (642 ± 102 g/mm2 vs. 636 ± 127g/mm2) and breaking extensibility (62. 2%± 18. 1% vs. 54. 4%±16. 0%) in the porcine values before and after decellularization. Subsequent seeding with rabbit BMSCs on the matrix was so successful that the surface of the scaffold had been covered with a continuous monolayer cells through light microscopy and electron microscopy. Positive of α-smooth muscle actin and negative of CD31 were observed after rabbit BMSCs seeded on the matrix through immunohistochemistry. Conclusion It is feasible to reconstruct TEHV in vitro on acellularized porcine aortic valve scaffold and rabbit BMSCs.

    Release date:2016-08-30 06:26 Export PDF Favorites Scan
  • Investigation of mid-to-long term quality of life and influencing factors in patients after heart valve replacement

    ObjectiveTo investigate the mid-to-long term quality of life (QOL) and influencing factors in the patients after heart valve replacement.MethodsConvenient sampling method was used to recruit 224 patients who had heart valve replacement surgery in our hospital from June 2008 to June 2017. There were 63 males and 161 females, aged 18-83 (51.49±10.60) years. General information questionnaire and MOS SF-36 scale were used to collect data. Univariate analysis and multiple linear regression analysis were used to analyze and determine the influencing factors for the QOL.ResultsThe total score of QOL of 224 patients was 71.78±17.60 points. All these scores of the patients were significantly lower than those of the general population of Chengdu (P<0.05) except the dimension of vitality. The QOL scores differences between sex, marital status, family income, working condition, the occurrence of anticoagulant complications and other complications were significant (P<0.05). Multivariate analysis showed that family income, working condition, the occurrence of anticoagulant complications and other complications could be included in the regression model, explaining 26.8% of total variance. ConclusionThe mid-to-long term QOL is lower in the patients after heart valve replacement. Family income, working condition, anticoagulant complications and other complications are the main influencing factors for mid-to-long term QOL for patients after heart valve replacement.

    Release date:2022-08-25 08:52 Export PDF Favorites Scan
  • 改良胸骨下段小切口心瓣膜置换术

    目的 探讨经改良胸骨下段小切口行心瓣膜置换术的适应证、手术方法和效果。 方法  81例心瓣膜病患者行二尖瓣置换术 4 0例 ,主动脉瓣置换术 18例 ,双瓣膜置换术 2 3例 ,三尖瓣成形术 2 9例 ,左心房血栓清除 +左心耳内缝扎术 19例。二尖瓣置换术、主动脉瓣置换术和双瓣膜置换术皮切口分别自第 4、第 3肋间水平至剑突根部 ,自下而上呈倒“J”形 ,纵行劈开胸骨分别至第 3、第 2肋间处向右侧弧形横断胸骨。切口长度 7~ 13cm。 结果 全组无手术和术后死亡 ,发生并发症 2例。主动脉阻断时间、体外循环时间、手术时间和住院时间分别为 4 6 .0± 31.6分钟、81.0± 4 7.8分钟、3.4± 1.0小时和 8.0± 2 .3天。术后胸腔引流量 2 5 0± 2 2 2 ml,有 6 2例 (76 .5 % )患者未输血。 73例随访 3个月~ 3年 ,所有置换的瓣膜位置和功能均正常 ,无瓣周漏。 结论 采用改良胸骨下段小切口行心瓣膜置换术安全可靠、美观、创伤小、恢复快 ,并不延长手术时间 ,早期结果满意。但须选择合适的手术适应证 ,手术者具有较熟练的心内手术技术。

    Release date:2016-08-30 06:28 Export PDF Favorites Scan
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