低尺寸的 mitra annuloplasty 在急性缺血性 mitra 吐期间改变左心室形状
Frederick A Tibayan1, Filiberto Rodriguez, Frank Langer
1Department of Cardiothoracic Surgery, Stanford University School of Medicine, Stanford, Calif 94305-5247, USA.
Circulation
|September 15, 2004
概括
伴心环解体术减少左心室 (LV) 弧度半径,减少LV壁应力和缺血性伴心回 (IMR) 中的氧气消耗. 这项研究提供了几何数据,支持IMR中annuloplasty的有益作用.
科学领域:
- 心血管外科心血管外科
- 心脏机械学 心脏机械学
- 生物医学工程 生物医学工程
背景情况:
- 左心室 (LV) 功能障碍显著影响因缺血性额外外 (IMR) 手术后的生存率.
- 精确的几何机制,其中状环无效整形减少了IMR的LV壁应力仍然不完全理解.
- 现有的数据缺乏精确的三维 (3D) 几何证据来支持这一假设,即解剖整形改变LV形状以减少墙壁应力.
研究的目的:
- 在急性IMR模型中,测试米特拉环状缩小减小区域周边LV曲率半径 (ROC) 的假设.
- 提供3D几何数据,证明结婚整形手术对LV几何和墙壁应力的影响.
主要方法:
- 八只成年绵羊接受了可调节的结婚整形和在LV和二手环环上植入的放射性不透明标记.
- 双平面视频光学用于在基线条件下研究动物,并在左环动脉阻塞期间收紧结合后收紧结合.
- 计算了末缩环形区域LV ROC和 mitra环形面积.
主要成果:
- 收紧结婚术线有效消除了急性IMR (MR等级从2.1到0.4).
- 年度减少显著降低了基底和赤道水平的末缩区域周边LV ROC (P<0.05).
- 在LV的前后区域观察到ROC的具体减少.
结论:
- 由环阻塞诱导的急性IMR增加了末缩LV曲率半径.
- 足以取消IMR的米特拉环状减小,降低了LV ROC,预计将减少LV壁应力和区域氧气消耗.
- 需要在慢性动物模型或患者中进行进一步的研究,以确定低尺寸结婚整形术对LV重塑和功能的长期影响.
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