ミトラル弁の修復において,拡張ポリテトラフルオロエチレンによる帯置換の10年間の経験
J Kobayashi1, Y Sasako, K Bando
1Department of Cardiovascular Surgery, National Cardiovascular Center, Osaka, Japan. jkobayas@hsp.ncvc.go.jp
Circulation
|November 18, 2000
まとめ
拡張ポリテトラフルオロエチレン (ePTFE) コーダル置換は,10年以上にわたって耐久的なミトラバルブ修復を提供します. このテクニックは,長期間,優秀な結果と,ミトラル逆吐症の患者における好ましい生物学的適応を示しています.
科学分野:
- 心血管外科手術についてです.
- バイオマテリアル科学 バイオマテリアル科学
- 医療エンジニアリング 医療エンジニアリング
背景:
- mitrale regurgitation (MR) は通常,ミトラル弁の修復で治療されます.
- 拡張ポリテトラフルオロエチレン (ePTFE) は,複雑なミトラバルブ修復のケースにおいて,帯置換に使用されます.
- ミトラル弁の修復におけるePTFEの長期的結果と物質の振る舞いは,さらなる調査を必要としています.
研究 の 目的:
- ミトラル弁の修復における人工コルダとして,EPTFEの長期的な耐久性と生物学的適応性を評価する.
- EPTFEコーダル置換によるミトラ弁修復を受ける患者の臨床結果と再手術率を評価する.
主な方法:
- 74人の患者からなるコホートは,1988年7月から1999年4月までの間に,ePTFEコーダル置換によるミトラル弁修復を受けた.
- 追跡期間は11.3年まで延長され,臨床評価とエコーカルディオグラフィーが行われました.
- エクスペラントされたePTFE素材の構造分析が行われました.
主要な成果:
- 研究によると,入院死亡率は1.4%で,心疾患による死率は4.1%と報告されています.
- 5年および10年後の精算的な再運用フリー率はそれぞれ94.3%および81.7%でした.
- 構造分析では,ePTFEの化がなく,柔軟性が保たれ,内皮化が確認されました.
結論:
- ePTFEは,長期間耐久性と,ミトラル弁の修復に適した生物学的適応性を示しています.
- ePTFEコーダル置換を用いたミトラ弁の修復は,長期間続くミトラ弁の排泄の管理に有効な選択肢です.
- ePTFEの内皮形成は,その抗血栓性特性に寄与する可能性があります.
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