Reasons and treatment methods of high transprothetic pressure gradient after aortic valve replacement
10.3760/cma.j.jssn.1673-4904.2016.10.007
- VernacularTitle:主动脉瓣置换术后产生高跨瓣压差的临床原因分析及治疗
- Author:
Jindong LI
;
Yanhong WU
;
Mingfeng DONG
;
Jiantang WANG
;
Shoudong CHAI
;
Peizhe TANG
;
Tao LIU
;
Zhenkun LI
;
Feng XIA
;
Shengjun MA
- Publication Type:Journal Article
- Keywords:
Heart valve diseases;
Heart valve prosthesis;
Retrospective studies
- From:
Chinese Journal of Postgraduates of Medicine
2016;39(10):883-885,886
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the reasons and treatment methods of high transprothetic pressure gradient after aortic valve replacement. Methods The clinical data of 45 patients with high transprothetic pressure gradient after aortic valve replacement were retrospectively analyzed. The patients were followed up for average 24.6 (12 - 40) months. The postoperative effective orifice area (EOA) of artificial valve was measured by transthoracic color Doppler ultrasound. Compared with published referred EOA of different artificial valve, there were 2 kinds results:measured EOA=referred EOA and measured EOA0.85 cm2/m2 and EOAI<0.85 cm2/m2. The reasons of high transprothetic pressure gradient were analyzed according to the above different standard. Results In the 45 patients with high transprothetic pressure gradient after aortic valve replacement, prosthesis-patient mismatch (PPM) was in 33 cases, and prosthetic dysfunction was in 10 cases, among whom 5 cases were because of thrombus (3 cases improved after increasing the dosage of warfarin, 2 cases underwent re-aortic valve replacement), 3 cases were because of severe bioprosthetic calcification (underwent re-aortic valve replacement), and 2 cases were because of prosthetic ring pannus and influenced movement of the leaflets (underwent re-aortic valve replacement). High flow in the left ventricular outflow tract occurred in 2 cases. The patients had no obvious discomfort, and did not receive special treatment. Four cases died, among whom 2 cases were because of severe PPM, and the other 2 cases were because of noncardiac. Conclusions Many reasons can result to the high transprothetic pressure gradient, and the PMM is the most common reason. Choosing the right treatment plan can improve the survival rate of patients.
