慢性缺血性二尖瓣关闭不全的外科治疗

Surgical Treatment of Chronic Ischemic Mitral Regurgitation

目的探讨慢性缺血性二尖瓣关闭不全的手术治疗方法和效果□方法 2 0 1 3年 3 月-2 0 1 6年 1 月,冠脉搭桥同期 行二尖瓣成形治疗二尖瓣关闭不全 2 0例,其中中度反流 1 2 例,重度反流 8 例 .全部使用二尖瓣成形环.结果 全组顺利出 院,17 例术后平均随访 18 个月,远期心功能 Ⅰ-Ⅱ级者 1 6 例, Ⅲ级 者 1 例 .术后超声复查左心室内径较术前明显缩小,瓣 膜功能良好.结论中度及以上缺血性二尖瓣关闭不全在冠脉搭桥术中应对发生病变的瓣膜进行手术处理,二尖瓣成形可获得满意的临床效果。

Objective To investigate the surgical treatment and effect of chronic ischemic mitral regurgitation. Methods Between March 2013 and January 2016 , 20 cases of mitral insufficiency received mitral valvuloplasty were treated by one - stage coronary artery bypass grafting, including moderate regurgitation in 12 cases and severe reflux in 8 cases. All the cases were performed with mitral valve rings. Results The whole group of cases was discharged smoothly. 17 cases were followed up for an average of 18 months？ 16 cases of long -term cardiac function grade I to [[ ？ and 16 cases of grade HI - Postoperative ul-trasound examination showed the significant decrease of left ventricular diameter compared with that of preoperative, and the valve function was good. Conclusion In terms of the moderate and above ischemic mitral regurgitation, the lesion of the valve should be surgically treated in the coronary artery bypass surgery, while mitral valvuloplasty can obtain satisfactory clinical results.