ヒトにおける大動脈弁の豚の異種移植の脈動性流れの特徴
L G Christie1, W W Nichols, C J Pepine
1Division of Cardiology, University of Florida College of Medicine, Shands Teaching Hospital, Gainesville, Florida 32610, USA.
Circulation
|September 1, 1978
まとめ
グルタルアルデヒドで固定された豚大動脈の異体移植は,上昇大動脈の優れた脈動性流動特性を示し,通常の弁をよく模倣しています. これは,この人工大動脈弁の長期にわたる良好なパフォーマンスを示唆しています.
科学分野:
- 心血管外科手術についてです.
- バイオメディカルエンジニアリング
- ヘモダイナミクス (血動力学)
背景:
- 大動脈弁置換 (AVR) は,重度の大動脈弁疾患の一般的な処置です.
- 義肢弁の血液動力学的性能の評価は,患者のアウトカムにとって極めて重要です.
- 豚の異種移植は,しばしば使用される義肢弁である.
研究 の 目的:
- グルタルアルデヒド固定された豚のヘテログラフトを使用してAVR後の昇動大動脈の脈動性流動特性を評価する.
- これらの流れ特性を通常の大動脈弁の流れ特性と比較する.
主な方法:
- 豚の異種移植によるAVRの12カ月後の14人の患者を調査した.
- 分析された速度信号は,ピーク速度,最大加速,ストローク容量,射出時間を測定します.
- 血流の可視化のために血管図の技術を活用した.
- 血流のパラメータを,正常な大動脈弁を持つ8人の患者からなる対照群と比較した.
主要な成果:
- バルバル大動脈のグラデーションは,義足弁の患者では最小でした.
- 昇動性大動脈の脈動性流速のパラメータは,正常な大動脈弁を持つ患者のそれとほとんど区別できなかった.
- アンジオグラフィーは,グループ間の血流パターンが類似していることを示した.
結論:
- グルタルアルデヒド固定された豚大動脈ヘテログラフトは,ネイティブ大動脈弁に匹敵する血液動力学的性能を示します.
- 流れの特徴の類似性は,この義肢弁の長期にわたる良好な機能の可能性を示唆しています.
- この豚の異種移植は,大動脈弁置換手術の有力候補である.
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