改良edge-to-edge二尖瓣成形术治疗成人二尖瓣前叶脱垂的作用

Effect of modified edge-to-edge mitral valve repair method for adult prolapse of the anterior leaflet

目的探讨改良edge-to-edge二尖瓣成形术在成人二尖瓣前叶脱垂手术治疗中的作用。方法回顾总结34例二尖瓣前叶脱垂患者经改良edge-to-edge二尖瓣成形术治疗的经验,此术式系在传统edge-to-edge成形术基础上加以改进,通过二尖瓣前、后叶缝合点的有效缝合,增加了前、后瓣叶对合缘的接触面积,同时辅以加强缝合线来调节瓣叶关闭程度,更好地改进了成形效果。结果经改良edge-to-edge二尖瓣成形术治疗的患者,术后超声心动图复查显示4例存在轻度二尖瓣反流,其余患者二尖瓣均不存在反流,心脏形态和心功能都有不同程度恢复。结论对于成人二尖瓣前叶脱垂导致的二尖瓣反流,改良edge-to-edge二尖瓣成形术可以有效的恢复瓣膜功能,改善心功能。

Objective To summarize the effect of modified edge-to-edge mitral valve repair for adult prolapse of the anterior leaflet. Methods The anatomy and clinical experience of 34 patients who were treated with modified edge-to- edge mitral valve repair method were reviewed. Modified edge-to-edge mitral valve repair was based on the traditional edge-to-edge mitral valve repair. It increased the contact area between the anterior and posterior leaflets through the ef- fective suture of the leaflets. And it also modified the shaping result by means of controlling the leaflets shuting extent. Results Among all the cases above, mild mitral regurgitation was observed by ultrasonic cardiogram only in 4 cases after operation, and no mitral regurgitation was observed in other cases. The heart morphology and functions of all the cases were recovered in different degree. Conclusion Modified edge-to-edge mitral valve repair method is effective for the adult patients with isolated prolapse of the anterior leaflet. It can recover valve fuction and improve heart function.