摘要目的 比较国产牛颈静脉带瓣BalMedic管道与同种异体带瓣管道(Homograft)在右心室流出道重建中的临床效果.方法 2003年1月至2009年7月,使用Homograft管道重建右心室流出道患者10例,使用BalMedic管道重建右心室流出道患者14例.术后1年复查超声心动图,检测移植管道内径、远端吻合口压差、新建肺动脉瓣跨瓣压差、有无血栓形成或瘤样扩张及肺动脉瓣反流程度.结果 Homograft组9例治愈出院,1例因感染性心内膜炎引起多器官功能衰竭死亡,与管道明确相关;BalMedic管道组13例治愈出院,1例于术后第2天因心力衰竭死亡.两组肺动脉瓣及远端吻合口均未见明显狭窄(压差＜ 20 mm Hg)(1 mm Hg=0.133 kPa),且组间差异无统计学意义(P＞0.05).两组均无血栓形成,且未见瘤样扩张.Homograft组肺动脉瓣轻度反流2例,中度1例;BalMedic管道组轻度反流4例,无中、重度反流.结论 对于右心室流出道重建,两种管道可获相同治疗效果.鉴于BalMedic管道方便获取、易于保存及更加匹配等特点,将有更好的应用前景.

abstractsObjective To compare the clinical efficacy of BalMedic bovine jugular vein conduit (BalMedic) with homograft in right ventricular outflow tract reconstruction.Methods Totally 10 patients were implanted homograft to reconstruct right ventricular outflow tract,while 14 patients were implanted BalMedic from January 2003 to July 2009,and the function of the implanted conduit was evaluated by Doppler echocardiography one year after operation.Results 9 patients in group Homograft were cured,while 1 patient died of multiple organ failuie caused by infective endocarditis,which was confirmed associated to the conduit.13 patients in group BalMedic were cured,while 1 patient died of heart failure 2 days after operation,which no independent with the conduit.No stenosis of the pulmonary valve and further stoma had been found in both two groups,and they were no significant different( P ＞0.05 ).There were no thrombus aud aneurysm in both two groups.Two patients in group Homograft had low-grade regurgitation with pulmonary valve,while one had middle-grade regurgitation.And 4 patients in group BalMedic had low-grade regurgitation with pulmonary valve,no else became worse.Conclusion Both homograft and BalMedic can be used in reconstruction of right ventricular outflow tract.BalMedic may have better prospect.