合并中度功能性二尖瓣关闭不全的主动脉瓣置换术同期行二尖瓣修复与无二尖瓣修复的近中期疗效分析

Aortic valve replacement in patients with moderate functional mitral regurgitation:an analysis of the efficacy of mitral valve repair versus mitral valve free repair

目的研究分析主动脉瓣置换术(AVR)同期二尖瓣修复或保守观察中度功能性二尖瓣关闭不全(FMR)对患者近中期预后的影响。方法收集2018年1月至2020年12月年在阜外华中心血管病医院接受AVR术前合并中度功能性二尖瓣关闭不全的72例患者的临床资料,其中男性55例、女性17例,年龄63(53,67)岁。根据同期有无修复二尖瓣将病例分为观察组和修复组。随访患者近中期的生存预后,以及FMR改善情况。结果中位随访时间12.6(8.3,15.4)个月。术后早期,观察组和修复组的FMR改善率为92.7%和100%(P=0.124);术后中期随访显示,观察组和修复组的FMR改善率分别为87.8%和100%(P=0.004)。结论二尖瓣修复与AVR同期进行具有可接受的手术风险,AVR同期行二尖瓣修复手术具有较好的临床结果。

Objective To explore the effect of aortic valve replacement(AVR)with mitral valve repair same time or not on patients in the near and medium term.Methods The clinical data of 72 patients who underwent AVR in the Central China Fuwai Hospital with moderate functional mitral valve insufficiency,including 55 males and 17 females,aged 63(53,67)years,which is collected from January 2018 to December 2020.The patients were divided into the observation group and repair group,according to whether the mitral valve was repaired at the same time.The survival and FMR improvement of the patients in the near to mid term were followed.Results The median follow-up was 12.6(8.3,15.4)months.The early postoperative improvement rate of FMR in the observation group was 92.7%and the repair group was 100%(P=0.124).The mid-term postoperative improvement rate of FMR in the observation group was 87.8%and the repair group was 96.8%(P=0.0044).Conclusion Concomitant mitral valve repair with AVR has an acceptable surgical risk.It has a better outcome for the mitral valve,zero mortality,and better clinical effect.