CAJ | 학술논문

目的探讨二尖瓣瓣膜成形术(MVP)治疗非风湿性二尖瓣关闭不全的临床效果.方法选择2006年1月至2013年11月内蒙古医科大学附属医院非风湿性二尖瓣关闭不全患者43例,病因包括先天性瓣叶脱垂、缺血性改变、退行性改变、感染性病变.手术方式为单纯瓣叶部分切除、单纯腱索短缩或转移、瓣膜裂修补、瓣叶部分切除+双孔成形、腱索短缩或转移+瓣膜裂修补、术中均放置二尖瓣成形环,同期冠状动脉旁路移植术,术中采用注水试验和食管内超声评价成形效果.结果术前超声心动图示二尖瓣均为中大量关闭不全,术中食管内超声发现中量关闭不全2例,改行二尖瓣置换术.43例患者中术后在院死亡1例.出院后随访1 ～83个月,平均(43±17)个月,无再次手术者,无死亡者,超声心动图示40例二尖瓣瓣膜成形术患者中无或少量二尖瓣关闭不全27例,少量到中量关闭不全13例.结论应用二尖瓣瓣膜成形术治疗非风湿性二尖瓣关闭不全是可行的,可以取得良好的效果.
목적 탐토이첨판판막성형술(MVP)치료비풍습성이첨판관폐불전적림상효과.방법 선택2006년1월지2013년11월내몽고의과대학부속의원비풍습성이첨판관폐불전환자43례,병인포괄선천성판협탈수、결혈성개변、퇴행성개변、감염성병변.수술방식위단순판협부분절제、단순건색단축혹전이、판막렬수보、판협부분절제+쌍공성형、건색단축혹전이+판막렬수보、술중균방치이첨판성형배,동기관상동맥방로이식술,술중채용주수시험화식관내초성평개성형효과.결과 술전초성심동도시이첨판균위중대량관폐불전,술중식관내초성발현중량관폐불전2례,개행이첨판치환술.43례환자중술후재원사망1례.출원후수방1 ～83개월,평균(43±17)개월,무재차수술자,무사망자,초성심동도시40례이첨판판막성형술환자중무혹소량이첨판관폐불전27례,소량도중량관폐불전13례.결론 응용이첨판판막성형술치료비풍습성이첨판관폐불전시가행적,가이취득량호적효과.
Objective To assess the results of mitral valve repair in patients with severe mitral regurgitation of nonrheumatic etiology.Methods Between January 2006 and November 2013,43 patients with severe mitral regurgitation of nonrheumatic etiology in the Affiliated Hospital of Mongolia Medical University.The etiology of mitral regurgitation was congenital,ischemic,degeneration,and infective endocarditis.Reparative procedures included ring cusp excision,chordal shortening or chordal transfer,cleft closure,cusp excision + double hole,and hordal shortening or chordal transfer + cleft closure,respectively,ring annuloplasty in all patients.Coronary artery bypass grafting in concomitantly.The valve repair results analyzed by the water injection test and the esophagus supersonic in intraoperative.Results Echocardiography documented that there were severe mitral regurgitation in all of patients preoperatively.The vavle replacement have 2 patients.the early mortality have 1 patient.Follow-up ranged from 1 to 83 months,mean(43 ± 17)months,27 patients had no or trivial mitral regurgitation,13 patients had trivial or moderate mitral regurgitation.Conclusion Mitral valve repair in nonrheumatic mitral regurgitation patients provides satisfactory results with current surgical techniques.