CAJ | 학술논문

目的:EMVP技术将脱垂的二尖瓣叶相对应的前后叶缝合起来,形成一个双孔二尖瓣,从而改变了二尖瓣的解剖形态,本文旨在研究组织多普勒在"缘对缘"二尖瓣成形术后左心室舒张功能的作用.方法:30例二尖瓣关闭不全患者根据成形方式被分成A、B组,A组:15例二尖瓣后叶脱垂患者接受后叶楔形切除;B组:15例前叶或双叶脱垂患者接受"缘对缘"二尖瓣成形术,所有患者均同时接受二尖瓣环成形.术前及术后1周,运用彩色多普勒、组织多普勒测定患者左心室舒张功能指标,包括:术前和术后E峰与A峰血流速比值(E/A),舒张期E峰血流速度与舒张早期二尖瓣环的最大运动速度的比值(E/Em), 舒张早期二尖瓣环的最大运动速度与舒张晚期二尖瓣环的最大运动速度的比值(Em/Am).结果:A组与B组成形术后二尖瓣口面积及二尖瓣反流程度均明显减小,E/A、E/Em及Em/Am在手术前后组间及组内之间均无明显变化.结论:组织多普勒能较好客观地评价"缘对缘"二尖瓣成形后左心室舒张功能,"缘对缘"二尖瓣成形技术效果良好,对左心室的舒张功能无明显影响.
목적:EMVP기술장탈수적이첨판협상대응적전후협봉합기래,형성일개쌍공이첨판,종이개변료이첨판적해부형태,본문지재연구조직다보륵재"연대연"이첨판성형술후좌심실서장공능적작용.방법:30례이첨판관폐불전환자근거성형방식피분성A、B조,A조:15례이첨판후협탈수환자접수후협설형절제;B조:15례전협혹쌍협탈수환자접수"연대연"이첨판성형술,소유환자균동시접수이첨판배성형.술전급술후1주,운용채색다보륵、조직다보륵측정환자좌심실서장공능지표,포괄:술전화술후E봉여A봉혈류속비치(E/A),서장기E봉혈류속도여서장조기이첨판배적최대운동속도적비치(E/Em), 서장조기이첨판배적최대운동속도여서장만기이첨판배적최대운동속도적비치(Em/Am).결과:A조여B조성형술후이첨판구면적급이첨판반류정도균명현감소,E/A、E/Em급Em/Am재수술전후조간급조내지간균무명현변화.결론:조직다보륵능교호객관지평개"연대연"이첨판성형후좌심실서장공능,"연대연"이첨판성형기술효과량호,대좌심실적서장공능무명현영향.
Objective:Edge-to-edge mitral valve plasty technique anchors the correspondence leaflet to create a double-orifice mitral valve, and it absolutely changes the original mitral valve anatomy.This study was aimed to assess tissue Doppler imaging for left ventricular diastolic function after edge-to-edge mitral valve plasty. Method:Thirty patients with mitral regurgitation were included and divided into 2 groups. Quadrangular resection was operated on fifteen cases with posterior proplapse in group A, and Edge-to-edge mitral valve plasty was underwent on fifteen cases with anterior or bileaflet proplapse in group B. To evaluated the left ventricular diastolic function. The ratio pf the peak E velocity and A velocity(E/A), the ratio of the early diastolic peak flow velocity to the early diastolic mitral valve annular movement velocity(E/Em), and the ratio of early diastolic mitral valve annular movement velocity to late diastolic mitral valve annular movement velocity(Em/Am)were measured before operation and 1 week after operation respectively.Result:The mitral valve area and the mitral regurgitant grade were decreased dramatically after operation in both groups. The evaluations of E/A, E/Em, and Em/Am were no significant difference between two groups and in each group before and after operation. Conclusion:Tissue Doppler imaging is a good way to evaluate left ventricular diastolic function after edge-to-edge mitral valve plasty, and this procedure has no significant influence on left ventricular diastolic function with satisfactory results.