人工弁に関する研究 : とくにWada-Cutter弁の心音図学的研究
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概要
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During the period varying from seven days to four years after surgery, phonocardiograms, carotid pulse tracings and apexcardiograms were recorded on the fifty patients who underwent cardiac valve replacement with Wada-Cutter valve. They consist of twenty- four aortic valve replacements, twenty-one mitral valve replacements. three tricuspid valve replacements and three triple (aortic, mitral, tricuspid) valve replacements. Measurements described below were made on those recordings and they were compared both with normal valves and with those obtained from valve replacements using other than Wada-Cutter valve and following conclusions were drawn. Aortic Valve Replacement: 1. By means of stethoscope, on opening clicks were heard but characteristic systolic murmur and closing clicks of the prosthesis were well audible. However those clicks were more faint than those of caged ball valve and they were considered to be mentally less annoying the patient. 2. On the phonocardiogram, diamond-shaped systolic murmur, of ejection type, was recorded following the opening click of prosthesis. However this dose not mean a presence of stenosis created by the prosthesis but was considered to be brought about rather by the turbulance produced by Wada-Cutter valve. 3. Q-M_I interval, mean 0.084 seconds, appeared to have little more prolonged than normal and the hypothesis, that the presence of rigid metal ring of prosthesis hampers closing motion of the mitral valve, was considered to be the cause of that prolongation. 4. M_I-OC interval, mean 0.044 seconds, was considered to be within normal range but it was assessed to be little shorter than those of ball valve was deduced to open more easily than the other type of prosthesis. 5. OC-CC interval, left ventricular ejection time, mean 0.326 seconds, was measured to be little longer than normal. The prolongation was partly attributed to the trivial stenosis caused by prosthesis but another major etiology was considered to be present because the mean pressure gradient has been found to be approximately 5 mmHg in the series of pressure monitorings. 6. The results of analysis of carotid pulse tracing graded Wada-Cutter valve to be within normal range or little excess in the degree of stenotic effect and it well corresponded with the results of pressure monitoring.
- 社団法人日本循環器学会の論文
- 1971-12-20
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