二尖瓣修复成形术的临床研究

A clinical study on the mitral valvuloplasty

目的分析二尖瓣修复成形术治疗二尖瓣关闭不全患者的方法及疗效。方法对30例二尖瓣关闭不全患者行二尖瓣修复成形术。其中瓣膜退行性变10例、先天性心脏病合并二尖瓣关闭不全19例,黏液瘤合并二尖瓣关闭不全1例。采用瓣叶切除修复、瓣环成形、腱索缩短以及缘对缘等单一或联合术式。通过术中注水试验、食管超声以及术后心功能改善情况来判断二尖瓣成形手术的效果。结果30例患者全部存活,术中注水试验良好。术后心功能改善Ⅰ级28例、Ⅱ级2例,随访1~5年无患者再次行二尖瓣置换术。结论选择合适患者,采用单一或联合二尖瓣成形方法治疗二尖瓣关闭不全,可以取得满意的疗效。

Objective To analyze the effect of 30 mitral insufficiency treated with mitral valvuloplasty. Methods Thirty patients with mitral insufficiency underwent mitral valvuloplasty. The etiological factors included congenital in 19 patients, degenerative mitral prolapse or chordae rupture in 10, left atrial rnyxoma with rnitral insufficiency in 1. The valvuloplasty technique included sliding technique, anuloplasty, chordal transfer and edge to edge technique. The outcome of mitral valvuloplasty was evaluated by allusion test, transesophagus echocardingraphy intraoperatively and improvement of cardiac function postoperatively. Results There was no perioperative death in the 30 patients, and no one received valve replacement afterwards. Allusion test intraoperafively showed that mitral valves functioned well. Cardiac function was assined in Ⅰ dagree in 28 cases and Ⅱ in 2 cases during 1 to 5 years follow up. Conclusion Satisfactory results of valuuloplasty can be obtained in the patients with mitral insufficiency if the selection of indications is proper.