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英文誌(2004-)

Journal of Medical Ultrasonics

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1993 - Vol.20

Vol.20 No.11

Original Article(原著)

(0625 - 0630)

Annuloplasty Ringの僧帽弁輪動態への影響
: 心尖部断層心エコー図法による検討

Influence of Rigid or Flexible Mitral Annuloplasty Ring on Mitral Annular dynamics
: A Two-Dimensional Echocardiographic Study

山浦 泰子1, 吉川 純一 1, 吉田 清1, 赤阪 隆史1, 赤土 正洋1, 八木 登志員1, 前西 文秋1, 岡田 行功2

Yasuko YAMAURA1, Junichi YOSHIKAWA1, Kiyoshi YOSHIDA1, Takashi AKASAKA1, Masahiro SHAKUDO1, Toshikazu YAGI1, Humiaki MAENISHI1, Yukikatsu OKADA2

1神戸市立中央市民病院循環器センター内科, 2神戸市立中央市民病院循環器センター胸部外科

1Department of Cardiology Kobe General Hospital, 2Department of Cardiovascular surgery Kobe General Hospital

キーワード : Mitral annuloplasty ring, Mitral valve repair, Mitral annular motion

To observe the effect of rigid (Carpentier) and flexible (Duran) annuloplasty rings on the dynamics of the mitral annulus in patients who had undergone mitral valve repair, 19 patients were studied via a two-dimensional echocardiography. Seven patients had a Carpentier ring and twelve had a Duran annuloplasty ring. The mitral leaflets and annular attachments were recorded from a veiw close to the standard apical long axis view. The transducer was rotated and recordings were made at 30° rotational intervals around the circumference of the mitral valve annulus. To reconstruct the annulus, the diameters (or chords) from each rotational interval were arranged around a reference point. The annular area were planimetered. The annular movement was reduced in all 7 patients with a Carpentier ring. In all 12 patients with a Duran ring, the annular area increased during diastole and became maximum in late diastole. There was some presystolic narrowing, followed by further systolic narrowing to the minimal size, which was reached in midsystole. Annular size increased in late systole and in isovolumic relaxation. In 7 patients with a Carpentier ring, the annular area did not change significantly during cardiac cycle. In conclusion, a flexible Duran annuloplasty ring is more physiological than a rigid Carpentier ring.