应用自体心包瓣膜成型

Heart valve repair with auotogolous pericardial

目的探讨应用自体心包进行心脏二尖瓣、三尖瓣瓣膜成型的技术特点和可行性,评价其术后效果。方法2005年1月至2006年6月我院采用自体心包成型心脏瓣膜6例,其中男性4例,女性2例。先天性心脏病室间隔缺损合并感染性心内膜炎致三尖瓣关闭不全2例,致二尖瓣关闭不全1例;黏液变性二尖瓣关闭不全3例。4例二尖瓣病变采用了双孔成形技术,同时用自体心包片制作成形环,替代人造瓣环或自体心包片修补后叶。2例三尖瓣病变用自体心包片修补三尖瓣前瓣叶以及隔瓣,瓣环再行Devaga环缩。结果6例患者均顺利出院,随访3个月。术后患者二尖瓣、三尖瓣反流程度均有明显改善(P<0.05),心功能均有明显提高(P<0.05)。结论自体心包材料能最大限度地发挥瓣膜成型手术的优势,降低并发症和手术费用,近期效果良好。

Objective To review our experience of heart valve repair with auotogolous pericardial and assess the clinic results. Methods From Jan 2005 to Jun 2006, 6 patients were underwent valve repair.4 cases were male, 2 cases were female. 4 patients with mitral valve regurgitation（ myxomatous disease in 3 cases,ventricular septal defect accompanied with endocarditis in 1 cases）. 2 patients with tricuspid valve regurgitation （ventricular septal defect accompanied with endocarditis）. Repairing mitral valve regurgitation with auotogolous pericardial ring ＆ double orifice technique, repairing tricuspid valve regurgitation with auotogolous pericardial path ＆ De vaga technique.All patients were performed under extracorporeal circulation. Results 6 patients had uneventfull recovery. All patients were follow up 3 months. The grade of valve regurgitation decrease significiently. 3 months after opertion, New York Heart Association （NYHA） functional class of the patients improved significantly（P〈0.05）. Conculsion Repairing heart valve regurgitation with auotogolous pericardial is a safe and easily reproducible method with early good results.