| 摘要: |
| 目的：研制可经导管植入的带瓣膜三尖瓣支架，探索置换三尖瓣的技术。方法：用超弹性镍钛记忆合金丝编织双盘状网状支架，两盘中间有腰部连接，内置瓣膜环。将新鲜的羊心包脱细胞处理后给予0.6%戊二醛浸泡48 h后缝合在瓣膜环上，制成带瓣膜三尖瓣支架。取离体的山羊心脏标本，用输送鞘管经下腔静脉穿过三尖瓣口，打开右室面，回拉鞘管，确认右室面卡住瓣环口后，释放右房面，完成体外经导管植入实验。注水实验观察瓣膜启闭功能。结果：制备的带瓣膜三尖瓣支架可牢固地置于自体瓣环位置，反复牵拉后未见支架脱入心腔，同时观察到原有三尖瓣瓣叶、腱索等均被夹在双盘状支架之间，瓣下结构无破坏。瓣膜启闭功能良好。结论：人工带瓣膜三尖瓣支架设计合理，可经导管安全释放，瓣膜功能良好。 |
| 关键词: 三尖瓣 支架 心导管术；心脏瓣膜植入 |
| DOI：10.3724/SP.J.1008.2008.00200 |
| 投稿时间：2007-06-25 |
| 基金项目:国家高科技研究发展计划(“863”计划)(2006AA02Z4D7). |
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| Preparation of valved tricuspid stent and in vitro experimental implantation to tricuspid position through catheter |
| BAI Yuan,ZONG Gang-jun,QIN Yong-wen*,,WANG Hong-ru,JIANG Hai-bin |
| (Department of Cardiology, Changhai Hospital, Second Military Medical University, Shanghai 200433, China) |
| Abstract: |
| Objective：To prepare valved tricuspid stent and to discuss the techniques of transcatheter tricuspid valve replacement in vitro. Methods: We designed a selfexpandable stent made of superelastic NiTi shape memory alloy. The stent was composed of double disks with tubular linkage between them. A valvular ring made of nitinol wire was sutured on the tubular part. Fresh sheep pericardium was decellularized, treated with 0.6% glutaraldehyde solution for 48 h and then sutured on the valvular ring. Through a 16French sheath positioned in the right ventricle of isolated sheep heart via vena cava, the device was delivered into the tricuspid valve. When the right ventricle disk was deployed, it was applied to the tricuspid annulus by pulling back the external sheath. Then the waist and the right atrial disk were deployed in the annulus and right atrium, respectively, by pulling the sheath. Thus the whole device was deployed in the native tricuspid. Water was injected into the right ventricle to test the competence of the prosthetic heart valves. Results: The prepared valved tricuspid stent could be stably positioned at the native valves. There was no stent migration when it was repeatedly pulled. The two disks sandwiched the native tricuspid valve with one disk lying in the right ventricle and the other one in the right atrium. The prosthetic heart valves showed satisfactory function without structure damage. Conclusion: This selfexpandable stent is well designed and can be safely implanted in the tricuspid valve position via transcatheter approach; and the function of the stent is satisfactory. |
| Key words: tricuspid valve stents heart catheterization heart valve prosthesis implantation |
