| Konno法和改良Manougnian法行主动脉瓣置换术的临床结果 |
| 投稿时间：2011-08-08 修订日期：2011-10-12 点此下载全文 |
| 引用本文：朱亚彬,朱兵,杨岷,石维平,王宁夫,K.M.Cherian,刘志勇.Konno法和改良Manougnian法行主动脉瓣置换术的临床结果[J].医学研究杂志,2012,41(5):149-152 |
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| 中文摘要:目的观察Konno法和改良Manougnian法行主动脉瓣置换术的中期效果。 方法2001年7月~2009年11月对30例小主动脉瓣环青少年患者施行瓣环扩大的主动脉瓣置换术，其中 Konno法12例（Konno组），改良Manougnian 法18例（Manougnian组），比较术前和出院时、术后3年时超声心动图指标。结果术后住院死亡1例，随访29例，随访率100%，术后左心室厚度、左心室重量指数均较术前明显改善，术后平均随访3年，心功能恢复程度无明显差别。但动态EOAI差异显著， Konno法较改良 Manougnian法有较低的迟发性人工瓣膜不匹配现象发生；两组方法术后中期生存率无差异；术后3年左心室重量指数、左心室厚度、跨瓣压差有显著差异，Konno法较改良 Manougnian心律失常发生率高。结论两种扩大瓣环方式行主动脉瓣置换术在青少年患者中均能达到满意的短期效果和中期生存率，动态EOAI提示Konno法较改良 Manougnian法更能减少人工瓣膜不匹配现象。 |
| 中文关键词:瓣膜置换 Konno手术 Manougnian手术 EOAI |
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| Intermediate-term Clinical Outcomes of Konno and Modified Manougnian Methods on Adolescent Patients for Enlargement of Aortic Annulus |
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| Abstract:ObjectiveTo evaluate intermediate-term results of Konno and modified Manougnian methods on adolescent patients who underwent enlargement of aortic annulus for aortic valve replacement. MethodsFrom July 2001 to Sep 2009, 30 patients underwent enlargement of aortic annulus to replace the large aortic valve prosthesis by using Konno operation and modified Manougnian operation. The dynamic change of EOAI and other relative indexes were reviewed by echocardiography(UCG) during follow-up.ResultsOne patient had inpatient death in Manougnian group, and 29 cases received mean 3 years follow-up. No significant difference was found between two groups for heart function at discharge. There was significant difference in dynamic change of EOAI between two groups after 3years follow-up. Regression of left ventricular wall thickness, left ventricular mass index were improved after operation,but left ventricular wall thickness, left ventricular mass index,peak aortic gradient, mean aortic gradient had significant difference after 3 years follow-up. There was no difference for clinical symptom and heart function during 3 years follow-up in different groups. Konno group had lower incidence rate of delayed prosthesis-patient mismatch and higher arrhythmia than Manougnian group. Conclusion Both Konno operation and modified Manougnian operation can get satisfactory improvement for short-term survival in adolescent patients with small aortic annulus. In view of the dynamic change of EOAI, Konno operation can provide more enlargement of aortic annulus than modified Manougnian operation in replacement of the bigger prosthetic aortic valves and avoiding delayed prosthesis-patient mismatch during 3 years follow-up. |
| keywords:Heart valve replacement Konno operation Manougnian operation EOAI |
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