| 摘要: |
| 目的 通过体外实验初步探讨改良的血管缝合器经左心耳途径缝合左房室瓣的可行性,探索治疗左房室瓣反流的新技术。方法 对市售股动脉血管缝合器进行改良,剪除缝合器前端的延长管,保留使穿刺导丝通过的标记孔,将缝合器打开时的缝针针距适当增宽。取离体山羊心脏标本20只,打开心包膜暴露左心耳,用Cordis桡动脉穿刺针穿刺左心耳，送入普通“J”型导丝,沿室间沟剪开左心室,确认“J”型导丝在左心室内,从心耳侧沿该导丝送入改良的血管缝合器至左心室,在左房室瓣心室侧打开缝合器,回撤缝合器,将左房室瓣前、后瓣缝合在一起。结果 改良的血管缝合器可以成功地将左房室瓣前、后瓣膜缝合在一起,瓣膜及瓣下结构无破坏。结论 改良的血管缝合器设计合理,可以将左房室瓣前、后瓣缝合。 |
| 关键词: 缝合技术 血管缝合器 心脏导管插入术 左房室瓣 |
| DOI： |
| 投稿时间：2013-03-31修订日期：2013-06-09 |
| 基金项目:国家高技术研究发展计划(“863”计划,2006AA02Z4D7). |
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| Per-left auricle suture of mitral valve using modified vascular closure device: an in vitro experiment |
| LI Ming-hui,TAN Hong-wen,CHEN Xiang,ZHANG Zhi-gang,BAI Yuan,QIN Yong-wen* |
(Department of Cardiovasology, Changhai Hospital, Second Military Medical University, Shanghai 200433, China
*Corresponding author.) |
| Abstract: |
| Objective To investigate the feasibility of per-left auricle suture of mitral valve using modified vascular closure device via in vitro experiment, so as to search for new technique for treatment of mitral regurgitation. Methods The market vascular closure device was modified by cutting the tip of extension tube, while reserving the marking hole for passing the puncture wire and broadening the needle pitch. Twenty goat hearts were obtained and the pericardium was opened to expose the left auricle. After puncture of the left auricle with the Cordis needle, a “J” type guide wire was inserted through the needle sheath. It was confirmed that the “J” type guide wire must be in the left ventricle through cutting the left ventricle along the interventricular groove. Then the modified vascular closure device was introduced into the left ventricle along the “J” wire. The anterior leaflet and posterior leaflet of mitral valve were sutured together by the vascular closure device in ventricular side of the mitral valve. Results Our modified vascular closure device could successfully suture the anterior leaflet and posterior leaflet of mitral valve, without damaging the valve structure. Conclusion The modified vascular closure device is well designed and can be used for suturing anterior leaflet and posterior leaflet of mitral valve. |
| Key words: suture techniques vascular closure device heart catheterization mitral valve |
