ObjectiveTo investigate hemodynamic changes in the early postoperative period of isolated aortic valve replacement (AVR) with different types of 19-mm mechanical heart valves. MethodsClinical data of 116 patients with aortic stenosis who underwent AVR in Beijing Anzhen hospital from January 2007 to January 2012 were retrospectively analyzed. There were 61 male and 55 female patients with their age of 52±13 years. All the patients were divided into 3 groups according to different types of mechanical heart valves they received. In SJ. Regent valve group,there were 38 patients (33%) including 20 males and 18 females with their average age of 52±15 years. In Carbomedics valve group,there were 40 patients (34%) including 21 males and 19 females with their average age of 51±17 years. In On-X valve group,there were 38 patients (33%) including 20 male and 18 female patients with their average age of 55±16 years. Preoperative and postoperative left ventricular end-systolic diameter (LVESD) left ventricular end-diastolic diameter (LVEDD) ejection fraction (EF) interventricular septal thickness,left ventricular wall thickness,trans-aortic valve velocity and pressure,and postoperative effective orifice area index (EOAI) were compared. ResultsThere was no statistical difference in preoperative and postoperative LVESD,LVEDD,EF,interventricular septum thickness and left ventricular wall thickness among the 3 groups (P>0.05). There was statistical difference in preoperative and postoperative trans-aortic valve velocity and pressure. Trans-aortic valve velocity of SJ. Regent valve group and Carbomedics valve group (244.30±33.67 cm/s vs. 249.69±79.13 cm/s vs. 294.83±52.05 cm/s) and trans-aortic valve pressure of SJ.Regent valve group and Carbomedics valve group (27.77±3.33 mm Hg vs. 33.58±18.90 mm Hg vs. 38.56±13.21 mm Hg) were significantly smaller than those of On-X valve group. ConclusionSt. Regent and Carbomedics mechanical heart valves demonstrate better hemodynamics in AVR patients receiving 19-mm mechanical heart valves.
ObjectiveTo compare clinical outcomes between modified and traditional Morrow procedures for the treatment of hypertrophic obstructive cardiomyopathy (HOCM). MethodsForty-two HOCM patients undergoing surgical correction in Beijing Anzhen Hospital between January 2005 and July 2011 were recruited in this study. According to different surgical techniques, all the patients were divided into 2 groups. In traditional Morrow procedure group, there were 16 patients including 13 males and 3 females with their age of 49±15 years. In modified Morrow procedure group, there were 26 patients including 14 males and 12 females with their age of 40±18 years. Preoperative and postoperative echocardiography were performed to compare ventricular septal thickness (VST), left ventricular outflow tract velocity (LVOTV)and left ventricular outflow gradient (LVOG)between the 2 groups. ResultsVST, LVOTV and LVOG of HOCM patients were significantly reduced after both traditional and modified Morrow procedure. There was statistical difference in preoperative and postoperative VST (23.10±3.64 mm vs. 17.38±4.39 mm), LVOTV (433.08±101.68 mm/s vs. 248.46±101.88 mm/s)and LVOG (78.57±40.16 mm Hg vs. 4.29±21.52 mm Hg)in traditional Morrow procedure group (P < 0.05). There was statistical difference in preoperative and postoperative VST (25.04±47.05 mm vs. 18.38±6.55 mm, P < 0.05), LVOTV (414.83±83.33 mm/s vs. 159.72±60.84 mm/s, P < 0.05)and LVOG (77.94±29.16 mm Hg vs. 17.56±9.39 mm Hg, P < 0.05)in modified Morrow procedure group (P < 0.05). Preoperative and postoperative difference in LVOG of modified Morrow procedure group was more significant than that of traditional Morrow procedure group (74.25±27.91 mm Hg vs. 34.63±30.66 mm Hg, P < 0.05). ConclusionModified Morrow procedure is superior to traditional Morrow procedure in reducing postoperative LVOG for HOCM patients.