二尖瓣成形术治疗小儿先天性二尖瓣反流疗效分析

Mitral valvuloplasty for congenital mitral valve regurgitation in children

目的评价二尖瓣成形术在小儿先天性二尖瓣反流治疗中的应用效果。方法对接受二尖瓣成形术治疗的78例二尖瓣反流患儿的手术指征、手术方式、疗效及随访结果进行分析。结果 78例患儿平均随访时间12.6个月(0.5～73个月)。术后死亡3例,均为住院期间死亡。术后15例(19.2%)出现并发症。再次手术4例,其中3例行二尖瓣置换术,1例行二次成形术。1例因术后心力衰竭再次入院。随访期间二尖瓣反流评分与术前相比均有明显下降(P<0.05)。结论二尖瓣成形术治疗小儿先天性二尖瓣反流近期效果理想,能适应患儿的生长,可以有效地延迟或避免行二尖瓣置换术。

Objective To evaluate the application of mitral valvuloplasty to congenital mitral valve regurgitation in children.Methods The surgical indications,procedures,therapeutic effects and follow-up results of 78 children with mitral valve regurgitation undergoing mitral valvuloplasty were analysed.Results The average duration of follow up was 12.6 months(0.5 month to 73 months).Three patients died after operation during hospitalization.Postoperative complications occurred in 15 patients(19.2%).A second operation was performed in 4 patients,including mitral valve replacement(n=3) and redo mitral valvuloplasty(n=1).One patient was re-hospitalised due to heart failure.During the follow up,grades of mitral valve regurgitation were significantly decreased compared to those before operation(P0.05).Conclusion Mitral valvuloplasty in children may lead to favorable early outcomes,adapt to children's growth,and effectively delay or avoid mitral valve replacement.