二尖瓣成形术在婴幼儿先天性心脏病中的应用

Mitral valve reconstruction were performed in infants with congenital heart disease

目的:总结二尖瓣成形术在婴幼儿先天性心脏病(先心病)中的应用。方法:自2007年10月至2012年10月,108例二尖瓣关闭不全(不包括完全性或部分性房室通道)婴幼儿行二尖瓣成形手术,所有婴幼儿中有3例(2.7%)行再次二尖瓣成形术。术中根据瓣膜病变情况选择合适的成形方法,包括二尖瓣瓣环环缩、Wooler瓣环成形术、瓣裂修补、乳头肌缩短技术及复合技术。对所有患者均行临床和超声心动图检查评估二尖瓣功能。结果:全组婴幼儿无死亡病例,所有婴幼儿复查超声心动图提示:二尖瓣残留少量反流23例(21.3%),中度反流12例(11.1%),重度反流3例(2.7%),3例重度反流患儿分别于术后2年、2年9个月及4年行再次手术,再次手术后1例无反流,2例少量反流。结论:二尖瓣成形术是婴幼儿先心病中二尖瓣关闭不全手术的首选术式。

Objective： To summarize the experience of Mitral valve reconstruction in infants with con- genital heart disease. Methods ：There were 108 infants with mitral regurgitation （ total and partial atrioventric- ular canal defect were not included）were performed Mitral valve reconstruction, after surgical repair 3 patients （2. 7% ） were underwent reoperation from Oct 2007 to Oct 2012. Ring annuloplasty,Wooler commissural annu- loplasty, closure of the cleft chordal shortening technique, complex techinique. The mitral regurgitation were c- valuated with echocardiogram and clinical symptoms during and after the reoperation. Results： There were no early and later death during the follow-up. Echocardiogram showed the mitral was minimal regurgitation in 23 （21.3%） patient s, mild regurgitation in 12 patients （11.1%） ,maximal regurgitation in 3（2. 7% ）, after reo- peration of mitral regurgitation, 1 patient was no regurgitate, 2 patients were minimal regurgitate. Conclusion： Mitral valve reconstruction is still the first choice during mitral valvu｜oplasty in infants with congenital heart dis- ease, and the result was excellent.