二尖瓣成形術治療二尖瓣關閉不全臨床分析_《華西醫學》

作者：

舒駿 , 叢偉 , 陳凡 , 曾富春 , 甘崇志 , 劉勝中

四川省醫學科學院·四川省人民醫院心胸外科（成都，610072）;

關鍵詞：

二尖瓣成形術二尖瓣關閉不全

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目的　總結68例二尖瓣成形術的臨床經驗，評估其術后臨床效果。方法　回顧分析2001年12月－2011年12月進行二尖瓣成形術治療的68例二尖瓣關閉不全患者的臨床資料。成形術的方法為：人工瓣環植入、雙孔成形、后瓣矩形切除、贅生物切除及心包補片修復、腱索轉移等。術中采用注水實驗和經食管超聲心動圖檢查評估成形效果。結果　68例患者中手術死亡2例，二次開胸止血1例，肺部感染3例。全部患者術中注水實驗和食管超聲心動圖檢查顯示成形效果滿意。存活66例患者隨訪6個月，術后10 d、6個月彩色多普勒超聲心動圖檢查：左心房內徑、左心室舒張末內徑縮小。術后6個月彩色多普勒超聲心動圖檢查：無或微量反流33例，輕度反流27例，輕～中度反流5例，中度反流1例。結論　根據二尖瓣關閉不全的特征，選擇相應的二尖瓣成形技術，可以取的較好的臨床效果。

引用本文： 舒駿,叢偉,陳凡,曾富春,甘崇志,劉勝中. 二尖瓣成形術治療二尖瓣關閉不全臨床分析. 華西醫學, 2012, 27(7): 1007-1010. doi: 復制

1.	Onnasch JF, Schneider F, Mierzwa M, et al. Mitral valve repair versus replacement [J]. Z Kardiol, 2001, 90 (Suppl 6): 75-80.
2.	Gillinov AM, Cosgrove DM 3rd. Current status of mitral valve repair[J]. Am Heart Hosp J, 2003, 1(1): 47-54.
3.	劉維永, 楊景學, 張偉達, 等. 二尖瓣綜合成形術——臨床病理研究與手術策略探討[J]. 中華外科雜志, 1994, 32(1): 4-7.
4.	Morimoto H, Tsuchiya K, Nakajima M, et al. Mitral valve repair for extended commissural prolapse involving complex prolapse[J]. Asian Cardiovasc Thorac Ann，2007, 15(3): 210-213.
5.	Alfieri O, Maisano F, De Bonis M, et al. The double-orifice technique in mitral repair: a simple solution for complex problems[J]. J Thorac Cardiovasc Surg，2001, 122(4): 674-681.
6.	Gillinov AM, Cosgrove DM. Chordal transfer for repair of anterior leaflet prolapse[J]. Semin Thorac Cardiovasc Surg, 2004, 16(2): 169-173.
7.	Fucci C, Sandrelli L, Pardini A，et al. Improved results with mitral valve repair using new surgical techniques[J]. Eur J Cardionthorac Surg, 1995, 9(11): 621-626.
8.	Brown ML, Schaff HV, Li Z, et al. Results of mitral valve annuloplasty with a standsard size posterior band: is measuring important [J]. J Thorac cardiovasc Surg, 2009, 138(4): 886-891.
9.	Eisenmann B, Charpentier A, Popescu S, et al. Is a prosthetic ring required repair of mitral insufficiency duo to posterior leafet prolaose? Long-tem results in 96 patients submitted to repair with no ring[J]. Eur J Cardiothorac Sug, 1998, 14(6): 584-589.
10.	彭永宣，魯亞南，丁文祥, 等. 二尖瓣成形術治療小兒先天性二尖瓣反流療效分析[J]. 上海交通大學學報（醫學版）, 2011, 31(9): 1295-1298.
11.	Lorer G, Kalil RA, Barcellos C, et al. Valve repair in children with congenital mitral lesions late clinical results[J]. Pediatr Cardiol, 2001, 22(1): 44-52.
12.	EI Oumeiri B, Boodhwani M, Glineur D, et al. Extending the scope of mitral valve repair in rheumatic disease[J]. Ann Thorac Surg, 2009, 87(6): 1735-1740.
13.	Ng CK，Punzengruber C, Pachinger O, et al. Valve repair in mitral regurgitation complicated by severe annulus calcification[J]. Ann Thorac Surg, 2000, 70(1): 53-58.
14.	Fernandez J, Joyce DH, Hirschfeld K, et al. Factors affecting mitral valve reoperation in 317 survivors after mitral valve reconstruction[J]. Ann Thorac Surg, 1992, 54(3): 440-448.
15.	Enriquez- Sarano M, Tajik AJ, Schaff HV, et al. Echocardiographic prediction of left ventricular function after correction of mitral regurgitation: results and clinical implications[J]. J Am Coll Cardiol, 1994, 24(6): 1536-1543.
16.	Stewart WJ. Choosing the “golden moment” for mitral valve repair[J]. J Am Coll Cardion, 1994, 24(6): 1544-1546.

1. 　Onnasch JF, Schneider F, Mierzwa M, et al. Mitral valve repair versus replacement [J]. Z Kardiol, 2001, 90 (Suppl 6): 75-80.
2. 　Gillinov AM, Cosgrove DM 3rd. Current status of mitral valve repair[J]. Am Heart Hosp J, 2003, 1(1): 47-54.
3. 　劉維永, 楊景學, 張偉達, 等. 二尖瓣綜合成形術——臨床病理研究與手術策略探討[J]. 中華外科雜志, 1994, 32(1): 4-7.
4. 　Morimoto H, Tsuchiya K, Nakajima M, et al. Mitral valve repair for extended commissural prolapse involving complex prolapse[J]. Asian Cardiovasc Thorac Ann，2007, 15(3): 210-213.
5. 　Alfieri O, Maisano F, De Bonis M, et al. The double-orifice technique in mitral repair: a simple solution for complex problems[J]. J Thorac Cardiovasc Surg，2001, 122(4): 674-681.
6. 　Gillinov AM, Cosgrove DM. Chordal transfer for repair of anterior leaflet prolapse[J]. Semin Thorac Cardiovasc Surg, 2004, 16(2): 169-173.
7. 　Fucci C, Sandrelli L, Pardini A，et al. Improved results with mitral valve repair using new surgical techniques[J]. Eur J Cardionthorac Surg, 1995, 9(11): 621-626.
8. 　Brown ML, Schaff HV, Li Z, et al. Results of mitral valve annuloplasty with a standsard size posterior band: is measuring important [J]. J Thorac cardiovasc Surg, 2009, 138(4): 886-891.
9. 　Eisenmann B, Charpentier A, Popescu S, et al. Is a prosthetic ring required repair of mitral insufficiency duo to posterior leafet prolaose? Long-tem results in 96 patients submitted to repair with no ring[J]. Eur J Cardiothorac Sug, 1998, 14(6): 584-589.
10. 　彭永宣，魯亞南，丁文祥, 等. 二尖瓣成形術治療小兒先天性二尖瓣反流療效分析[J]. 上海交通大學學報（醫學版）, 2011, 31(9): 1295-1298.
11. 　Lorer G, Kalil RA, Barcellos C, et al. Valve repair in children with congenital mitral lesions late clinical results[J]. Pediatr Cardiol, 2001, 22(1): 44-52.
12. 　EI Oumeiri B, Boodhwani M, Glineur D, et al. Extending the scope of mitral valve repair in rheumatic disease[J]. Ann Thorac Surg, 2009, 87(6): 1735-1740.
13. 　Ng CK，Punzengruber C, Pachinger O, et al. Valve repair in mitral regurgitation complicated by severe annulus calcification[J]. Ann Thorac Surg, 2000, 70(1): 53-58.
14. 　Fernandez J, Joyce DH, Hirschfeld K, et al. Factors affecting mitral valve reoperation in 317 survivors after mitral valve reconstruction[J]. Ann Thorac Surg, 1992, 54(3): 440-448.
15. 　Enriquez- Sarano M, Tajik AJ, Schaff HV, et al. Echocardiographic prediction of left ventricular function after correction of mitral regurgitation: results and clinical implications[J]. J Am Coll Cardiol, 1994, 24(6): 1536-1543.
16. 　Stewart WJ. Choosing the “golden moment” for mitral valve repair[J]. J Am Coll Cardion, 1994, 24(6): 1544-1546.

《華西醫學》

二尖瓣成形術治療二尖瓣關閉不全臨床分析

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《華西醫學》

二尖瓣成形術治療二尖瓣關閉不全臨床分析

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