保留二尖瓣全部或部分结构对行瓣膜置换术患者左心功能的影响

Preservation of the entire or partial mitral subvalvular apparatus on the left ventricular function

目的:对比研究保留二尖瓣全部结构或部分结构对行瓣膜置换术患者左心功能的影响。方法:对48例二尖瓣关闭不全或以二尖瓣关闭不全为主的患者,采用保留二尖瓣全部或部分结构的手术方法,于术前、术后24h采用漂浮导管监测血流动力学指标;术前、术后2～3周、术后6个月用心脏超声监测左心功能指标。结果:保留二尖瓣全部结构组术后心排指数、每搏指数、左室每搏做功指数、肺毛细血管楔压、左室射血分数、短轴缩短率均优于保留部分组或不保留组。结论:患者术后早期左心功能的改善保留全部二尖瓣结构组,优于保留部分组和不保留组。

Objective: To evaluate the effect of preservation of the mitral subvalvular apparatus on the left ventricular function for patients with mitral valve insufficiency. Methods: Fourty-eight patients were performed mitral valve replacemont (MVR) through preservation of the entire or partial mitral subvalvular apparatus,measured hemodynnamic parameters 24 hours pre-and postoperation,examined the dimensions and ejection function by echocardiography preoperation,2～3 weeks postoperation,and 6 months postoperatively. Results: Cardiac index,stroke volume index,left ventricular stroke work index postoperatively,PCWP,LVEF,LVFS were better,in group preserved the entire mitral subvalvular apparatus than those in group partial or non preserved. Conclusion: The preservation of entire mitral subvalvular apparatus improves the left ventricular functions after MVR in patients with mitral valve insufficiency.