二尖瓣替换术保留或不保留后叶及瓣下结构对左室收缩功能的影响

The Effects of Mitral Replacement on Systolic Left Ventricular Functions in Patients with Preservation of the Posterior Leaflet and Subvalvular Structures Versus Resection

观察了１７例二尖瓣替换术病人，其中８例保留后叶及瓣下结构为观察组；９例常规方法手术为对照组。术后二维超声心动图测定左室缩短分数、射血分数及左室后壁底部、中部和心尖部缩短分数和运动速率，两组间无统计学差异。结果提示对风心病二尖瓣狭窄为主的病人，因慢性纤维瘢痕累及后叶和瓣下结构，换瓣时切除后叶及瓣下结构对左室后壁收缩功能无明确影响。

Mechanical mitral valve replacement was performed on 17 patients with preservation of the posterior leaflet and its subvalvular structures in 8 and without in 9 (control group). Postoperative left ventricular functions were studied by 2-D echocardiogram in both groups and were compared. There was no significant difference in EF and FS of left ventricle, and FS and Q-d time at the base, middle part and apex of the posterior wall of left ventricle. The clinical findings indicate little ventricular functional impairment after MVR in the control group of patients with chronic rheumatic MS resulting in scar formation involving the leaflet and subvalvular structures.