310例保留后瓣的二尖瓣人工瓣置换术的临床分析

Clinical analysis of 310 cases mitral valve replacements with leaflet and subvalvue structures preserved

目的 总结保留二尖瓣后瓣及瓣下结构的二尖瓣置换术的临床效果.方法 完成保留二尖瓣后瓣及瓣下结构的二尖瓣置换术310例,男112例,女188例,均为风湿性心脏病.术前心功能分级（NYHA）I级33例,II级119例,III级126例,IV级32例.结果 术后死亡2例,随访6个月~6年,无死亡病例,心功能I-Ⅱ级.结论保留二尖瓣后瓣及瓣下结构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 leaflet and subvalve structures preserved.Methods 310 patients,including 112 males and 188 female,underwent mitral valve replacements with preservation of mitral posterior leaflet and subvalve structures,both of them suffered from rheumatic heart disea-ses.Preoperatively,33 cases were in NYHA function class I and 119 cases in class II and 126 cases in class III and 32 cases in class IV.Results postoperative death were 2 cases.The follow-up ranged from 0.5 to 6 years.No late postoperative death,with heart function in class I-II.Conclusion Mitral valve replacements with preservation of mitra-l posterior leaflet and subvalve structures is a safe and effective surgical technique,it can reduce the risk of postoperative left ventricle rupture and improve the left ventricular ejection frac-tion.