肺弁の機能 肺弁の機能は,全身循環における肺弁の機能である
K J Jenkins1, F L Hanley, S D Colan
1Department of Cardiology, Children's Hospital, Boston, MA 02115.
Circulation
|November 11, 1991
まとめ
新大動脈弁として再利用された肺弁は,動脈スイッチ手術 (ASO) や左心臓症候群 (HLHS) 修復などの複雑な心臓手術の後,高頻度で再発を示しています. しかし,有意な狭窄は観察されず,ほとんどの場合,許容可能な長期的な機能を示す.
科学分野:
- 心血管外科手術についてです.
- ペディアトリック・カルディオロジー
- 生まれながらの心臓病 生まれながらの心臓病
背景:
- 肺弁は,複雑な先天性心臓手術でネオアート弁として再利用される.
- 循環中の肺弁の長期的機能は十分に理解されていません.
研究 の 目的:
- 肺弁をネオアート弁として使用する時の肺弁の長期的機能を調査する.
- 特定の外科的処置後の新大動脈吐および狭窄の発生率を評価する.
主な方法:
- 189人の患者のエコーカーディオグラム,キャセテリゼーションデータ,および血管図の遡及的レビュー.
- 動脈スイッチ手術 (ASO),低プラスティ性左心症候群 (HLHS) 修復,および肺動脈から大動脈への (P-A) アナストモシスの後のアウトカムの分析.
- バルブ機能に影響を与える要因の検討,手術前の解剖,肺動脈帯 (PAB),および追跡期間を含む.
主要な成果:
- 新大動脈の再発は,ASO後の41%で,HLHS修復後の60%で,P-Aアナストモシス後の50%で観察されました.
- わずか8人の患者が軽度/軽度以上の嘔吐を経験し,新大動脈狭窄は観察されなかった.
- 以前のPAB配置は,2段階のASO後に再発症の可能性を高め,無傷の心室隔膜はASO患者でより高い再発症と関連していました.
結論:
- 肺弁は新大動脈弁として機能し,高頻度で吐が起こりますが,長期的には狭窄が最小限に抑えられます.
- 前回のPABおよび心室隔膜の整合性などの要因は,特定の先天性心臓手術後の新大動脈吐に影響します.
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