“瓣中瓣”法行二尖瓣置换术28例临床分析

Clinical analysis of 28 cases of mitral valve replacements with all subvalve structures preserved

目的 总结保留全部二尖瓣瓣下结构的二尖瓣置换术的临床效果.方法 完成保留全部二尖瓣瓣下结构的二尖瓣置换术28例,男17例,女11例,均为二尖瓣关闭不全.术前心功能分级（NYHA） Ⅱ级12例,Ⅲ级16例.结果 全组无手术死亡,无术后并发症（低心排综合征、严重心律失常、二次开胸止血）,随访心功能I~Ⅱ级.结论 保留全部二尖瓣瓣下结构的二尖瓣置换术可减少左心室破裂的危险,改善术后心功能.

Objective To summarize the clinical effect of mitral valve replacements with all subvalve structures preserved. Methods A total of 28 patients, including 17 males and 11 females, under.vent mitral valve replacements with preservation of all subvalve structures,both of which suffered from mitral incompetence. Preoperatively,12 cases were in NYHA function class II and 16 cases in class III. Results There was no operative death and no postoperative complications （low cardiac output,severe arrhythmia and reoperation for hemostasis following open-heart surgery）. Follow-ups showed that all the cases were successfully recovered,with heart function in class I - II. Conclusions Mitral wlve replacements with preserwtion of all subwlve structures is a safe and effective surgical tech- nique,which can reduce the risk of post-operative left ventricle rupture and improve the left ventrieular ejection fraction.