保留全瓣及瓣下结构的二尖瓣置换术治疗老年退行性瓣膜病的进展

Progress in Mitral Valve Replacement of Complete Apparatus Preservation in Treating Senile Degenerative Valvular Heart Disease

老年退行性瓣膜病的发病率近年来有逐渐增加的趋势。严重的退行性二尖瓣病变需要外科手术治疗。老年患者的病程较长,各重要脏器功能退化不全,手术病死率较高,术后并发症发生率较高。保留全瓣及瓣下结构的二尖瓣置换术能保持瓣叶、腱索、乳头肌与左心室之间的正常联系,维护了心室壁原有的收缩支撑力,从而避免严重并发症和改善术后左心室功能,提高老年退行性瓣膜病的手术治愈率和维持较好的远期心功能状况。该文就保留全瓣及瓣下结构的二尖瓣置换术治疗老年退行性瓣膜病的临床应用进行综述。

The morbidity of senile degenerative valvular heart disease has been increasing in recent years.Severe cases need surgery.Because of the long course of disease and functional failure of important organs,the surgical mortality and complication rate of mitral valve replacement is still high in elder people.Mitral valve replacement of complete apparatus preservation can keep the normal connection of valvular leaflet,tendinous chorda,papillary muscle and ventricle,and maintain the original constriction support of ventricular wall,so as to avoid severe complications and promote left ventricular function after surgery,and increase the cure rate of senile degenerative valvular heart disease and preserve better heart function of long term.Here is to make a review of the clinical application of mitral valve replacement of complete apparatus preservation in surgical therapy for senile degenerative valvular heart disease.