超声心动图评价二尖瓣前叶脱垂缘对缘成形术效果

Evaluation of the effect of edge-to-edge technique of anterior valve prolapse by echocardiography

目的应用经胸超声心动图（TTE）评价二尖瓣前叶脱垂缘对缘成形术效果。方法随机对19例二尖瓣前叶脱垂患者行缘对缘成形术患者术前及术后进行TTE检查，检测二尖瓣反流（MR）程度、二尖瓣口面积（MVA），左房、左室大小，左室射血分数（LVEF）及肺动脉收缩压（PASP）。结果二尖瓣前叶脱垂缘对缘成形术前瓣膜重度反流19例，术后无反流1例，轻微反流15例，轻度反流3例；术前左房大小为（51．63±10．03）mm，术后为（44．79±9．22）mm（P=0．000）；术前左室大小为（59．37±8．29）mm，术后为（52．68±7．31）mm（P=0．000）；术前PASP为（45．37±18．34）mmHg（1mmHg=0．133kPa），术后为（33．00±9．43）mmHg（P＝0．002）；术前MVA为（4．13±0．24）cm^2，术后为（2．90±0．28）cm^2（P=0．000）；术前LVEF为（66．0±9．0）％，术后为（67．0±6．0）％（P=0．751）。结论缘对缘成形术是一种简单、有效保留瓣下结构，恢复左房、室正常形态，维护左室功能的手术方法。

Objective To evaluate the effect of edge-to-edge technique of anterior mitral valve prolapse using transthoracic echocardiography （TTE）. Methods Nineteen patients with anterior mitral valve prolapse underwent randomized operation using edge-to-edge technique. The grade of mitral regurgitation（MR）,mitral valve are （MVA）,the diameter of left atrial（LAD） and left ventricle（LVD）,left ventricular ejection fracion（LVEF） and pulmonary artery systolic pressure（PASP） were evaluated. Results All the patients with anterior mitral valve prolapse had severe MR before the operation whereas the degree of MR changed into absence to mild degree after the procedure. There were significant statistic differences between pre and post edge-to edge procedure：LAD（51.63 ± 10.03）mm vs （44.79 ± 9.22）mm, P = 0. 000, LVD（59. 37 ± 8. 29） mm vs （52.68 ± 7.31）mm, P = 0.000;PASP（45.37± 18.34）mm Hg vs （33.00 ± 9.43）mm Hg, P = 0.002,1 mm Hg = 0.133 kPa;MVA（4.13 ± 0.24）cm^2 vs （2.90 ± 0.28）cm^2, P = 0. 000,while LVEF changed little[（66. 0± 9. 0）% vs（67.0±6.0）%,P =0.751]. Conclusions Theedge- to-edge technique is a simple and effective surgical method which can remain subvalve structure,restore the normal morphology of left atria,left ventricle and maintain the function of left ventricle.