Aortic Imaging: Your Questions Answered
52:04-53:35
Q:
Somebody says every time I get an echo and they're post-surgery they have a quote-unquote increased gradient pressure. Can you explain what that is, why, how it affects, what's the effect of that?
術後の心エコーレポートで、「increased gradient pressure（圧較差上昇）」というコメントを毎回書かれます。これはどういう意味ですか？
A:
Is that heart surgery already? They've had surgery and they have increased radiant pressure so what is increased gradient pressure what are they talking about? It's in the echo report. Yeah gradient, right yes, yeah so I'm assuming they have had a surgery for aortic valve and af, and the aneurysm, a Bentall kind of surgery with the graft and the bioprosthetic valve so that what ends up happening is natural valves produce they have maximum opening and produce very less gradient across that valve in the sense that the pressure change across that valve or velocity change across that valve is less but when you put a bioprosthetic valve, which is not an ideal valve, right? It doesn't last forever. It lasts about 10 to 15 years. There is a great inherent pressure gradient across the valve. There is flow gradient across the valve that increases as the age of this bioprosthetic valve happens over a period of 10 years because of wear and tear. If it acutely happens right after the bioprosthetic valve is because they may have had blood clots or something on the valve but usually the gradient increases as it gets older.
質問者さんには大動脈瘤の所見があり、ベントール術など、生体弁と人工血管による大動脈弁置換手術を受けたのだと推測されます。正常な大動脈弁であれば、完全に開き切るため、弁周囲の圧力変化や流速変化は少なくなり、圧較差は非常に低くなります。一方、生体弁は10～15年の耐用年数であり、圧較差は高くなる性質があります。術後10年以上経過すると弁の傷みが進み、圧較差は上昇してきます。術後すぐに圧較差が上昇したのであれば、血栓が原因と考えられますが、一般には時間経過と共に上昇してきます。
The Marfan Foundation did not participate in the translation of these materials and does not in any way endorse them. If you are interested in this topic, please refer to our website, Marfan.org, for materials approved by our Professional Advisory Board.
The Marfan Foundation は、当翻訳には関与しておらず、翻訳内容に関してはいかなる承認も行っておりません。このトピックに興味をお持ちの方は、Marfan.org にアクセスし、当協会の専門家から成る諮問委員会が承認した内容をご参照ください。
