二尖瓣成形术46例临床分析

Clinical analysis of 46 cases underwent mitral valve repair

目的:总结二尖瓣成形术的治疗经验。方法:回顾近2年我科46例行二尖瓣成形术患者的临床资料。瓣膜病变:风湿性7例、退行性变5例、先天性33例、缺血性1例。手术在中低温体外循环心内直枧下进行,二尖瓣按瓣下、瓣叶和瓣环的顺序成形,同时矫治合并的心血管畸形。结果:全组无围术期死亡,并发症包括:心包积液2例,胸腔积液3例,低心排综合征1例。术后超声心动图提示二尖瓣未见返流41例,残留反流5例,其余患者恢复良好,心功能较术前明显改善。结论:在严格掌握手术适应症的前提下,二尖瓣成形术可取得良好的效果。

Objective: This paper is to summarize the clinical experience of mitral valve repair. Methods:Data of forty-six patients underwent mitral valve repair were retrospectively analyzed, which involved 7 cases of rheumatic heart disease, 5 cases of degeneration heart disease, 33 cases of congenital heart disease, 1 case of ischemia heart disease. The operations were carried out under hypothermia cardiopulmonary bypass. The surgical procedure involved sub-valvular, valve, valve ring repair; coexistence cardiac diseases treatment; those were corrected simultaneity. Results: There was no operative mortality. Two cases were complicated with pericardial effusion, 3 cases were with thoracic effusion, 1 case with low cardiac output syndrome after the operation. Postoperative echocardiography indicated mitral insufficiency was completely corrected in 41 patients,residual mitral insufficiency was in 5 patients. Conclusion:Mitral valve repair can achieve good results when we control the indication strictly.