图示以前的球形笼式机械瓣膜,使用寿命长,但由于是非生物性的,因此需要连续抗凝治疗。左侧为心房面,右侧为心室面。优点是能象正常瓣膜一样开关。
人工瓣膜有以下并发症:
1、血栓形成:多见于机械瓣膜,需要病人进行持续抗凝治疗。
2、感染:感染后会在瓣膜周围形成赘生物,接着也会出现脓毒败血症。
3、结构破坏:主要见于生物瓣膜,瓣叶变硬、钙化。
4、人工瓣膜开裂:瓣膜与心脏的粘合处分离。
5、与心功能不协调:瓣膜可能与心脏不协调,血液流量没有达到最佳。
This is a mechanical valve prosthesis of the older ball and cage variety. Such mechanical prostheses will last indefinitely from a structural standpoint, but the patient requires continuing anticoagulation because of the exposed non-biologic surfaces. The superior aspect (here the left atrium) is seen at the left, while the outflow is at the right into the left ventricle in this mitral valve prosthesis.
A variety of problems can complicate prosthetic heart valves:
Thrombosis: this is a major potential problem with mechanical heart valves, requiring that the patient remain on anticoagulant therapy, though this will not entirely prevent thrombosis and subsequent embolization.
Infection: vegetations of infective endocarditis can develop on or around the prosthesis, and septic embolization can subsequently occur
Structural failure: this is a major problem with bioprostheses, because the leaflets tend to become stiff and calcify.
Dehiscence: seen mainly in the immediate postoperative period, dehiscence is separation of the prosthetic valve suture line from the heart, leading to paravalvular leakage
Disproportion: the prosthetic valve may not fit well in the heart, so that blood flow is not optimal.