新形式のカテーテル式人工大動脈弁（ｃａｔｈｅｔｅｒ‐ｍｏｕｎｔｅｄ　ａｏｒｔｉｃ　ｖａｌｖｅ：ＣＡＶ）による大動脈弁閉鎖不全症の治療の試み

• 宮 淳

  筑波大学臨床医学系外科

• 前田 肇

  筑波大学臨床医学系外科

• 堀 原一

  筑波大学臨床医学系外科

書誌事項

タイトル別名

• A new style catheter-mounted aortic valve for relief of aortic regurgitation.

抄録

For relief of aortic regurgitation (AR), we have developed a new style umbrella-shaped catheter-mounted aortic valve (CAV). This CAV is composed of a catheter, a main shaft which slides in the catheter, three flexible wires, which distal ends are fixed to the main shaft and proximal ones fixed to the catheter, and a valve sheet sutured to these flexible wires. Following insertion into the aortic annulus, the CAV is opened by means of pulling the main shaft to form an umbrella-like shape, so that the mid portions of each flexible wire make an arch and are fixed into Valsalva's sinuses (where the flexible wires are designed to form an outward protruded arch to fix the CAV satisfactory and not to obstruct coronary orifices.) The efficacy of this CAV was experimentally evaluated using 7 mongrel dogs with destroyed aortic valves. Formation of AR decreased diastolic and mean aortic pressure by 42.0mmHg and 30.3mmHg respectively, increased left atrial pressure by 8.7mmHg and decreased cardiac output by 46.4%. Under these conditions, insertion and application of the CAV increased diastolic and mean aortic pressure by 22.9mmHg and 16.2mmHg, respectively, decreased left atrial pressure by 3.1mmHg and increased cardiac output by 50.9%. Comparing with CAVs developed previously, the most remarkable advantage of this new style CAV is its stable fixation in the aorta brought about by three arched wires. This stability insured the prevention of regurgitation in diastole and decreased the risk of coronary orifice obstruction by the valve sheet. Accompanied with these considerable improvements of hemodynamics for AR, the advantages would bring a possibility of actual clinical use of this CAV.

収録刊行物

• 人工臓器

  人工臓器 14 (6), 1953-1958, 1985

  一般社団法人 日本人工臓器学会

キーワード

• Left heart failure
• Catheter-mounted aortic valve (CAV)
• Aortic regurgitation

詳細情報

• CRID: 1390282679934905088
• NII論文ID: 130001735619
• DOI: 10.11392/jsao1972.14.1953
• ISSN: 18836097
• ISSN: 03000818
• 本文言語コード: ja
• データソース種別:
  • JaLC
  • CiNii Articles
• 抄録ライセンスフラグ: 使用不可