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심장판막이식에 관한 연구

Orthotopic Atrio-Ventricular Valve Replacement With Semilunar Valve

최신의학 1970년 13권 6호 p.71 ~ 79
이영균, 최지원, 정경원, 손광현, 김규한,
소속 상세정보
이영균 (  ) - 서울대학교 의과대학 흉부외과학교실
최지원 (  ) - 서울대학교 의과대학 흉부외과학교실
정경원 (  ) - 서울대학교 의과대학 흉부외과학교실
손광현 (  ) - 서울대학교 의과대학 흉부외과학교실
김규한 (  ) - 서울대학교 의과대학 흉부외과학교실

Abstract


Recently many designs of prosthetic heart valvle were utilized in clinical application with a great scope. But it was found silicone rubber-ball or discoid and steel cage had been associated with some major difficulties; namely thrombo-embolism, ball variance, pressure gradient across the prosthesis, necessity for chronic anticagulation, and chronic low grade ´hemolytic anemia etc. Expense of the prosthesis is almost prohibitive in Korea also.
The homologous valve graft has advantage over prosthesis. Its central flow pathway is less obtrusive, flexible biological tissue can be incorporated into host tissue easily, no thrombo-embolic incidences even without anticoagulation, and easily controllable infection.
But its disadvantages are; problem in procurement of healthy, young, and immediately mortal case$ lack of choices of variable sizes, and the last but not the least problem is to get autopsy permission tin this area. To solve these problems in Korea heterograft seems to be the rational choice.
This preliminary study on heterologous heart valve graft was done on seventeen dogs. Fifteen canine tricuspid valves were replaced with ten pig pulmonary, four pig aortic, and one homologous aortic valve$: Two canine mitral valves were replaced with pig aortic valves.
The semilunar valves fixed in hand made make-shift strut was competent in every case, but strut ring and three prongs caused heart block which must be eradicated by improvement of valve strut design and operative methods.

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