三尖瓣成形术中人造瓣环尺寸的选择

发布时间：2019-03-31 18:01

【摘要】：目的综述三尖瓣病变的分类、解剖改变及病理生理变化过程,结合三尖瓣成形术中Carpentier的人造瓣环成形理论以及我中心选择三尖瓣人造瓣环尺寸的选择经验,探讨三尖瓣成形术中人造瓣环尺寸选择的适宜标准。方法通过搜索Medline及PubMed数据库有关三尖瓣人造瓣环尺寸选择的基础研究、临床统计相关文献,综合讨论三尖瓣人造瓣环尺寸选择标准的相同点与不同点。并对比我中心多例三尖瓣人造瓣环尺寸的选取与Carpentier人造瓣环成形理论的差异,分析探讨三尖瓣成形术中人造瓣环尺寸选择的适宜标准。结果与讨论 Carpentier以隔瓣基底部长度为测量标准的人造瓣环成形理论仍是目前选择三尖瓣人造瓣环尺寸的主流理论。但越来越多的学者提出了相反的意见,主张适当减少测量的隔瓣长度或以测量与前乳头肌腱索相连的瓣叶组织表面积作为三尖瓣人造瓣环尺寸的选择标准。我中心三尖瓣人造瓣环成形术中以测量瓣叶面积作为成形环大小的选择标准,从而使人造瓣环更好的契合扩张的三尖瓣瓣环,达到满意手术效果。
[Abstract]:Objective to summarize the classification, anatomical changes and pathophysiological changes of tricuspid valve disease, combined with Carpentier's theory of artificial annulus annuloplasty in tricuspid valvuloplasty and the experience in choosing the size of tricuspid valve annulus in our center. To explore the appropriate criteria for the selection of artificial annulus size in tricuspid valvuloplasty. Methods by searching Medline and PubMed database about the basic research of tricuspid valve annulus size selection and clinical statistical literature, the similarities and differences of tricuspid valve annulus size selection criteria were comprehensively discussed. The difference between the size selection of tricuspid valve annulus in our center and the theory of Carpentier prosthetic valve ring was compared, and the suitable criteria for the selection of artificial valve ring size in tricuspid valvuloplasty were analyzed and discussed. Results and discuss that Carpentier's theory of artificial valve ring forming based on the base length of septum is still the mainstream theory in choosing the size of tricuspid valve annulus. However, more and more scholars have proposed to reduce the measured septum length or to measure the tissue surface area of tricuspid valve annulus as the choice criteria of tricuspid valve annulus size by measuring the surface area of the flap tissue connected to the anterior papillary tendinous chordae. In the central tricuspid valve annuloplasty, measuring the leaf area is the selection criterion of the shape ring, so that the artificial tricuspid annulus fits the dilated tricuspid annulus better, and achieves the satisfactory operation result.
【学位授予单位】：浙江大学
【学位级别】：博士
【学位授予年份】：2015
【分类号】：R654.2

【相似文献】