Gore-Tex人工腱索在二尖瓣综合成形技术中的应用研究

Application research of artificial Gore-Tex chordae in mitral valve valvuloplasty

目的评价二尖瓣综合成形应用Gore-Tex人工腱索治疗二尖瓣关闭不全的近、中期疗效。方法回顾性分析67例使用Gore-Tex作为人工腱索治疗二尖瓣关闭不全患者手术前后心功能、左心室、左心房内径和二尖瓣反流程度的变化。结果全组无住院死亡,每例平均使用人工腱索(2.01±1.25)根,术后1年左心房内径从术前(59.82±9.33)mm进行性减少至(43.26±6.81)mm(P<0.05),左心室舒张末内径从术前(68.36±7.62)mm减少至(50.31±6.42)mm(P<0.05),左心室收缩末内径从术前(49.37±5.92)mm减少至(37.55±7.17)mm(P<0.05),射血分数(EF)从术前的0.57±0.09提高至0.67±0.08(P<0.05)。术后1年随访超声检查二尖瓣无明显反流37例,微量反流22例,轻度反流8例。结论应用Gore-Tex人工腱索,采用二尖瓣综合成形治疗因腱索断裂或延长所致者二尖瓣关闭不全,近、中期疗效满意。

Objective To evaluate the clinical application and mid-term result of artificial Gore-Tex chordae transplant in mitral valvuloplasty .Methods 67 patients received mitral reconstruction with Gore-Tex sutures were analyzed retrospectively .The data of cardiac function ( EF ) , the diameter of left ventricular and left atria,the degree of mitral regurgitation were analyzed before and after operation .Results There were no death in this group .The average artificial Gore-Tex chordae used in each patient were 2.01 ±1.25 .The diameter of left atria reduced from(59.82 ±9.33)mm preoperation to(43.26 ±6.81)mm(P<0.05)one year after operation.The end diastolic diameter of left ventricular reduced from ( 68.36 ±7.62 ) mm to ( 50.31 ±6.42 ) mm ( P<0.05 ) , and the end systolic diameter reduced from ( 49.37 ±5.92 ) mm to ( 37.55 ±7.17 ) mm ( P<0.05 ) , the EF increased from 0.57 ±0.09 to 0.67 ±0.08 (P<0.05).No regurgitation in 37 cases,trivial in 22,and mild in 8 one year after operation evaluated with color Doppler echo .Conclusions Gore-Tex artificial chordae transplant has an excellent early and midterm outcomes of patients with mitral insufficiency caused by tendon ruptures or extension .