Thirty-day Outcomes of First-in-man Implantation of a Novel Transcatheter Edge-to-edge Mitral Repair System in Patients With Severe Mitral Regurgitation

Objectives:The aim of this multicenter,prospective,single-arm pilot study(ClinicalTrials.gov number:NCT05040074)was to observe the procedural and 30-day results of the novel transcatheter mitral valve repair system,SQ-Kyrin■-M Clip(Shenqi Medical,Shanghai,China),in patients with severe mitral regurgitation(MR).Methods:The heart team considered patients from 5 centers in China with clinically significant functional mitral regurgitation≥3+despite optimal medical therapy or degenerative mitral regurgitation≥3+with high surgical risk as candidates for transcatheter repair.All patients received transcatheter edge-to-edge mitral valve repair under general anesthesia.The primary outcome was technical success,which included all of the following measured at the exit from the catheterization laboratory:(1)absence of procedural mortality;(2)successful access,delivery,and retrieval of the device delivery system;(3)successful deployment and correct positioning of the frst intended device;and(4)no emergency surgery or reintervention related to the device or access procedure.The secondary outcomes included all-cause mortality,serious adverse events,device success,and procedural success 30 d after the intervention.Results:From June 2021 to December 2021,18 patients were enrolled in this study with age(75.7±7.4)years.Fifteen patients had MR 4+,while 3 had MR 3+.Technical success was achieved in all patients,including 6 degenerative mitral regurgitation and 12 functional mitral regurgitation patients.There was no all-cause mortality at 30 d.One patient had single leaflet device attachment within 30 d,which was regarded as a serious adverse event,and the patient was successfully treated with reintervention by implanting another clip.Another patient's transmitral gradient was 6 mmHg(>5 mmHg),with an effective orifice area of 2.57 cm^(2) after the procedure.Sixteen patients had device success and procedural success at 30 d postoperation.Fourteen patients had MR 1+,3 had MR 2+,and only 1 patient had MR 3+30 d after the procedure.Conclusions:The results of this feasibility study showed the efficacy and safety of the SQ-Kyrin■-M device in the Chinese population with severe MR,laying a solid foundation for a subsequent large-scale confirmatory study.

CHANGES OF PLASMA ENDOTHELIN CONCENTRATIONS BEFORE AND AFTER PERCUTANEOUS BALLOON MITRAL VALVULOPLASTY IN PATIENTS WITH MITRAL STENOSIS

Plasma concentrations of endothelin in bloor from the femoral vein and the antecubital vein were measured in 35 patients with mitral stenosis and heart failure before and after percutaneous balloon mitralvalvuloplasty(PBMV). The basal plasma concentrations of endothelin in blood from the antecubirtal vein in the patients were significantly higher than those in 32 control subjects (15. 40± 3. 32 vs. 9. 59± 2. 66 pg/ml, P<0. 001). Plasma endothelin concentrations in patients in New York Heart Association functional classes Ⅱ and Ⅲ were significantly higher than those in control subjects, respectively. The concentrations of endothelin in patients with atrial fibrillation were also significantly higher than those in patients with normal sinus rhythm. Ten to fifteen minutes after PBMV, plasma endothelin concentrations in blood from the femoral vein significantly decreased from 16. 14 ± 3. 34 to 13. 74 ± 3. 78 pg/ml (P<0. 01 ). Seventy-two hours after the procedure, the concentrations of endothelin in blood from the antecubital vein had fallen to 12. 31 ± 2. 55 pg/ml (P<0. 001 vs. before PBMV and control subjects). Plasma endothelin concentrations still tended to be higher in patients with atrial fibrillation than those in normal sinus rhythm, but the difference did not reach statistical significance. There were weak but significantly correlations of plasma endothe lin concentrations with the mean left atrial pressure (r= 0. 424 , P < 0.001 ), mean right atrial pressure (r=0. 323, P<0. 01), mean transmitral pressure gradient (r= 0. 397, P<0. 001), heart rate (r= 0. 350,P<0. 005)and mitral valve area (r=-0. 454, P<0. 001) in the patients before and after PBMV.

Clinical outcome of percutaneous balloon mitral valvuloplasty in 103 patients

Percutaneous balloon mitral valvuloplasty (PBMV) was performed in 103 consecutive patients with rheumatic mitral stenosis. PBMV was accomplished in 99 patients. Singnificant symptomatic improvement was achieved in 98 patients (98/99 , 99% ). Mean left atr

The Value of Perioperative Echocardiography in Percutaneous Balloon Mitral Valvuloplasty

in order to investigate the value of perioperative echocardiography in percutaneous balloon mitral valvuloplasty (PBMV),two-dimensional echocardiography (2-DE), Doppler echocardiography and color Doppler flow imaging (CDFI) were employed prior to PBMV in 52 patients and during or after PBMV in 15 patients. The results showed that TTE and TEE were helpful in the selection of candidates for 2-DE transseptal and balloon dilation procedures. Continuous monitoring of 2-DE, Doppler echocardiography and CDFI during PBMV could make this procedure safer and more effective, reduce X-ray exposure and avoid complications. Echocardiography was usefui in fluoroscopy and could be used for evaluation of the effects of operation.

IMPORTANCE OF ATRIAL CONTRIBUTION TO LEFT VENTRICULAR FILING IN MITRAL STENOSIS BEFORE AND AFTER BALLOON VALVULOPLASTY

To assess the importance of atrial contribution to left ventricular filling in mitral stenosis, Doppler echocardiography war performed in 31 patients with mitral stenosis and sinus rhythm before(all patients) and after (15 patients) percutaneous mitral balloon valvuloplasty. Percent atrial contribution was derived from the ratio of atrial velocity-time integral (VTI) to total mitral VTL.The percent atrial contribution correlated closely with mitral valve area (r=0.91, P<0.001) and was inversely related to mean pressure gradient across the mitral valve orifice (r= -0.68, P<0.01). The study indicates that the degree of mitral stenosis exeris a great effect on the importance of a trial contribution to left ventricular filling in patients with mitral stenosis and sinus rhythm.

Balloon Mitral Valvuloplasty in Rheumatic Double Orifice Mitral Valve

We are reporting four cases of acquired double orifice mitral valve (DOMV) of rheumatic etiology (rare) presenting as significant mitral stenosis (MS) treated successfully by percutaneous intervention. All four patients are young (3 males, 1 female) who presented with dyspnea of Newyork heart association (NYHA) class II with mean duration of 1.3 years. Typical clinical findings of MS were present in all. Echocardiography confirmed the diagnosis of moderate to severe MS of rheumatic etiology with double orifice of mitral valve of Trowitzsch incomplete bridge variety [1], giving appearance of two equal (like a pair of spectacles in one patient) or unequal size orifices (in three patients) in parasternal short axis view. Color Doppler examination revealed separate jets originating from each orifice, determined severity of the lesion and evaluated the eligibility for balloon mitral valvuloplasty (BMV). BMV was carried out under transeosophagial echo (TEE) guidance (for perfect septal puncture and crossing the separate orifices) using Inoue balloon of appropriate size (in accordance with patient’s height) with intention to break central fibrous strand converting into a single orifice. All four patients underwent successful BMV (clinical & ECHO criteria) after dilating the separate orifices (except case 4) but the fibrous strand could not be broken. Hence, this study shows that good results can be obtained in acquired double orifice mitral valve with significant MS with BMV even without breaking the fibrous strand. Considering rarity of isolated DOMV cases and rheumatic etiology being very rare, this report of four rheumatic acquired DOMV cases with successful BMV done with good result is significant.

Predictors of Complications during Percutaneous Multitrack Balloon Mitral Valvuloplasty

Background: Percutaneous mitral balloon valvuloplasty is the main procedure in mitral stenosis (MS). It can replace surgical commissurotomy in many cases;however, mitral regurgitation (MR) remains the major procedure complication. Objectives: This study was conducted to investigate predictors of MR as a complication followingpercutaneous mitral valvuloplasty (PMV) using multitrack balloon technique. Methods: This cohort study was conducted at both Menoufia University Hospital and Mabaret Misr Elkadima Hospital. We enrolled 121 patients with moderate to severe MS who were subjected to PMV using multitrack balloon technique during the period from October 2017 to October 2019. Transthoracic echocardiographic evaluation was performed for all patients before and after the procedure. Patients who developed severe MR post procedure were compared with other patients to identify important distinction points. Results: Most patients (N = 109, 90.1%) developed no/mild MR (group A), whereas 12 (9.9%) patients developed severe MR (group B) after PMV. Those who developed severe MR had significantly higher weight, height, body mass index, and body surface area (P value < 0.001 for each). Also, there was a significant difference between both groups regarding pre-operative Wilkins score (8.7 ± 1.3 for severe MR versus 7.9 ± 1.2 for No/Mild MR, P = 0.046). Patients who developed severe MR had higher incidence of other valvular lesions such as mild aortic regurgitation (91.7% versus 36.7%, P < 0.001), higher mitral valve (MV) commissural calcification (50.0% versus 14.7%, P = 0.008), pre-operative MR (100.0% versus 35.8%, P < 0.001), higher prevalence of atrial fibrillation (100.0% versus 38.5%, P < 0.001). Regarding balloon sizing, it was significantly higher among patients who developed severe MR compared with those having mild or no MR (P = 0.001). Multivariate regression analysis identified MV balloon sizing (OR 3.877, CI 95% 1.131 - 13.289, P = 0.031) and MV commissural asymmetry of calcification (OR 67.48, CI 95% 5.759 - 790.72, P = 0.001) as significant predictors of outcomes of MV commissurotomy. Conclusion: Mitral valve calcification, balloon sizing, and MV asymmetry are significant factors that can predict the development of MR after balloon valvuloplasty.

二尖瓣成形术治疗二尖瓣关闭不全的效果评价

目的 评价二尖瓣成形术(MVP)治疗二尖瓣关闭不全(MI)的效果。方法 选取2019年2月至2021年2月因二尖瓣中重度反流在广东省江门市中心医院施行瓣膜手术的患者90例,将其中行二尖瓣置换术(MVR)患者44例设为对照组,将行MVP的患者46例设为观察组。对比2组手术施行情况指标、术后心脏超声参数指标[左心房内径(LAD)、左心室舒张末期内径(LVEDD)、左心室射血分数(LVEF)]、术后病情转归指标以及随访期间手术疗效,记录2组术后2年内不良心脏事件发生情况。结果 观察组手术时间、体外循环时间、关胸时间、呼吸机使用时间、重症监护病房住院时间、拔管时间短于对照组,术中出血量、术后引流量少于对照组,术后LAD、LVEDD小于对照组,LVEF高于对照组,差异均有统计学意义(均P<0.05)。观察组术后1、2年二尖瓣反流量>3 ml的患者比例低于对照组[4.3%(2/46)比20.5%(9/44)、6.5%(3/46)比22.7%(10/44)],差异均有统计学意义(均P<0.05)。观察组术后2年内不良心脏事件发生率低于对照组(P<0.05)。结论 MVP治疗MI效果优良,能降低手术创伤与风险,改善心功能,促进病情尽早恢复,且并发症少。

国产第三代磁悬浮左心室辅助装置植入同期行二尖瓣成形术的初步评价

目的:探讨国产第三代磁悬浮Corheart 6左心室辅助装置(LVAD)植入同期行二尖瓣成形术(MVP)的安全性及有效性。方法:回顾性分析2021年10月至2023年3月于郑州大学华中阜外医院接受Corheart 6 LVAD植入同期行MVP的终末期心力衰竭患者13例。收集院内、随访时的死亡及并发症事件,观察患者的心肌损伤、肾功能、血液动力学和超声心动图指标变化。结果:13例患者围术期无死亡、无MVP相关并发症。平均随访(14.2±5.6)个月期间,11例(84.6%)完成随访,2例分别因新型冠状病毒肺炎、心脏骤停死亡,无中重度二尖瓣反流复发。与术前相比,患者术后24 h、72 h心输出量升高,中心静脉压、肺动脉收缩压(PASP)、平均肺动脉压(PAMP)降低,术后1周高敏心肌肌钙蛋白T升高,估算肾小球滤过率降低,差异均有统计学意义(P均<0.010)。超声心动图检查显示,与术前相比,术后1、6个月左心室射血分数虽升高,但差异无统计学意义(P均>0.017),而左心室舒张末期内径、PASP、PAMP降低差异均有统计学意义(P均<0.010)。结论:国产第三代磁悬浮Corheart 6 LVAD植入同期行MVP安全、可行,术后近中期无中重度二尖瓣反流复发,肺动脉压显著降低,血液动力学显著改善。

全胸腔镜二尖瓣置换术同期心脏不停跳三尖瓣成形术安全性及有效性的临床研究

目的比较全胸腔镜二尖瓣置换术同期行三尖瓣人工瓣环成形术与正中开胸二尖瓣置换术同期行三尖瓣人工瓣环成形术的手术结果及短期疗效。方法回顾性分析2014年1月至2021年12月在广西壮族自治区人民医院接受二尖瓣置换术同期行三尖瓣人工瓣环成形术治疗三尖瓣反流(TR)的94例患者临床资料。68例接受正中开胸二尖瓣置换术同期心脏不停跳三尖瓣人工瓣环成形术(正中开胸组),26例接受全胸腔镜二尖瓣置换术同期心脏不停跳三尖瓣人工瓣环成形术(全胸腔镜组)。通过倾向性匹配评分(PSM)减少选择偏倚,最终得到26对病例进行分析。比较两组基本信息、手术治疗及术后随访资料,包括心脏彩超结果、手术住院相关指标等。结果全胸腔镜组手术时间、体外循环时间及阻断时间长于正中开胸组,差异有统计学意义(P<0.05)。术后1个月心脏彩超检查结果显示,两组二尖瓣收缩期血流速度、二尖瓣压差、压力减半时间(PHT)、TR面积、右心房内径(RAD)、右心室内径(RVD)以及房颤发生率比较差异无统计学意义(P>0.05)。两组术后24个月TR复发率比较差异无统计学意义(P>0.05)。术后24个月心脏彩超检查结果显示,正中开胸组二尖瓣压差显著低于全胸腔镜组(P<0.05),但两组二尖瓣收缩期血流速度、PHT、TR面积、RAD、RVD、左心室射血分数(LVEF)以及瓣周漏、房颤、肺动脉高压发生率比较差异无统计学意义(P>0.05)。结论全胸腔镜二尖瓣手术置换术同期行三尖瓣人工瓣环成形术与正中开胸二尖瓣置换术同期行三尖瓣人工瓣环成形术的疗效相当,两种手术方式均可用于临床治疗二尖瓣、三尖瓣联合瓣膜病变。

1275例二尖瓣反流患者行全胸腔镜微创二尖瓣成形术的长期随访结果分析

目的明确全胸腔镜微创二尖瓣成形术(TCMI-MVP)在治疗二尖瓣反流(MR)的安全性、有效性和耐久性。方法回顾性分析2009年1月1日至2022年6月1日在广东省人民医院接受TCMI-MVP的1275例MR患者的中远期结果。根据随访结果将患者分为MR未复发组(A组,1098例)和MR复发组(B组,177例),比较两组术前、术中、术后资料以及随访情况。结果随访率为96.24%,中位随访时间为4.42(0.00,13.20)年。整个队列患者1年、3年、5年和10年的生存率分别为99.5%、98.5%、97.8%和95.5%。两组生存预后差异无统计学意义(χ^(2)=0.350,P=0.554)。当未考虑死亡为竞争风险时,整个队列患者1年、3年、5年和10年MR≥2+的复发豁免率分别为90.4%、87.4%、85.6%和78.3%。当考虑死亡为竞争风险时,术后进展为MR≥2+的累积发生率在1年、3年、5年和10年时,分别为9.6%、12.5%、14.3%和21.4%。通过多因素Cox回归分析发现,患有高血压[HR(95%CI)=1.70(1.18~2.44),P=0.004]、同时行三尖瓣成形手术[HR(95%CI)=1.65(1.16~2.36),P=0.006]、较大的术前左心室收缩末期内径[HR(95%CI)=1.09(1.03~1.15),P=0.002]、较大的术后1周左心房内径[HR(95%CI)=1.03(1.01~1.06),P=0.031]和术后1周MR分级程度高[HR(95%CI)=59.63(21.84~162.82),P<0.001]是MR复发的危险因素。总体患者1年、3年、5年和10年再次二尖瓣手术的豁免率分别为99.6%、98.9%、98.7%和97.9%。结论先进瓣膜中心合理地运用各项修复技术行TCMI-MVP是安全、有效的,可获得良好的远期修复效果。

胸腔镜下二尖瓣成形术治疗二尖瓣关闭不全的应用

二尖瓣关闭不全(MR)是心脏瓣膜疾病中常见的疾病类型,胸腔镜下二尖瓣成形术(MVP)治疗MR是一种新兴的微创手术方式,该手术具有创伤小、术后恢复快等优点,受到广大患者及心脏外科医生的青睐,但其手术技术难度高、外科医生学习曲线较长。本文拟结合临床经验分享经胸腔镜下MVP治疗MR的具体操作步骤。

心腔内超声指导下经皮二尖瓣球囊成形术2例

过去30年间,经皮二尖瓣球囊成形术在X线和床旁超声指导下完成。但仍有部分大心房的二尖瓣狭窄患者行球囊扩张失败。心腔内超声指导下经皮二尖瓣球囊成形术精准可行,可减少并发症的发生,提高该类高龄复杂病例的成功率。本病例报道2例重度二尖瓣狭窄患者,经心腔内超声引导行经皮二尖瓣球囊成形术,手术成功,未发生相关并发症,为临床治疗二尖瓣狭窄提供一定的参考。

二尖瓣手术联合三尖瓣修复治疗老年退行性二尖瓣关闭不全并发三尖瓣轻中度反流及环形扩张的临床研究

目的:探讨老年退行性二尖瓣关闭不全合并三尖瓣轻度、中度反流伴环形扩张病人采用二尖瓣置换(MVR)同期三尖瓣成形术(TVP)治疗的效果。方法:对我院2016年1月—2021年1月实施手术治疗的95例老年退行性二尖瓣关闭不全合并三尖瓣轻度、中度反流伴环形扩张病人进行回顾性分析。仅采取MVR治疗的47例病人作为对照组,MVR同期TVP实施手术的48例病人作为研究组,比较两组病人手术过程及术后恢复指标、手术前后超声心动图指标、三尖瓣反流程度分级、并发症发生率。结果:研究组手术时间、主动脉阻断时间、体外循环时间均明显长于对照组,差异均有统计学意义(P<0.05);两组重症监护室(ICU)停留时间、心包纵隔引流量、呼吸机使用时间比较,差异均无统计学意义(P>0.05)。术后24个月,两组右心房内径(RVEDD)、右心室舒张末期内径(RV)、三尖瓣舒张期瓣环径(DTV)、动脉高压(SPAP)测定值均较术前明显降低(P<0.05),两组左室短轴缩短率(LVFS)较术前均明显提高(P<0.05);研究组RA、RVEDD、DTV、SPAP明显低于对照组,LVFS明显高于对照组,差异均有统计学意义(P<0.05)。术后24个月,研究组无反流23例、轻度反流25例,对照组无反流4例、轻度反流14例、中度反流29例,研究组术后的三尖瓣反流病情明显减轻(P<0.05)。两组手术后并发症发生率比较差异无统计学意义(P>0.05)。结论:老年退行性二尖瓣关闭不全合并三尖瓣轻度、中度反流伴环形扩张病人采用MVR同期TVP治疗较单纯的MVR治疗临床效果更好,且不会增加手术并发症发生率。

胸腔镜微创二尖瓣成形术后再次换瓣的相关因素分析

目的:探讨胸腔镜微创二尖瓣成形术后再次换瓣的相关因素分析及处理策略。方法:回顾性分析2019年3月至2021年12月,我院收治的103例胸腔镜微创二尖瓣成形患者,术后随访6个月。在术前、术后1周、3个月及6个月,参照心脏病协会(New York Heart Association,NYHA)心功能标准对患者进行心功能评级,并比较术前、术后1周、3个月及6个月患者LVEF、LAD、LVEDD以及二尖瓣反流量,并筛选出成形术后需要再次换瓣的患者,分析首次成形术后主要并发症及患者再次换瓣主要病因。结果:103例患者中首次手术病因为二尖瓣退行性变92例,二尖瓣风湿性改变11例。成形术后5例需要再次换瓣,病因为风湿性病变2例,退行性病变3例。术后早期并发症主要为肺部感染、低氧血症、多脏器衰竭、大量出血、低心排综合征、急性左心衰竭及新发心房颤动。术后6个月随访死亡2例。相较于术前,术后1周患者心功能分级、LVEF、LAD、LVEDD有所恢复,而术后6个月恢复程度显著(P<0.05),但需要再次换瓣的5例患者,无明显改善。结论:风湿性二尖瓣病变以及退行性病变都有可能为胸腔镜微创二尖瓣术后再次换瓣的原因。患者行再次换瓣术时需重点关注高危因素及患者心功能,并选择合适手术方式,术后需做好围术期处理、出院指导以及随访工作。

优质护理在经导管行二尖瓣成形术患者围手术期的护理效果

目的探讨经导管行二尖瓣成形术的围手术期应用优质护理的效果。方法选取我院2020年1月至2023年2月收治的经导管行二尖瓣成形术患者112例,依据入院时间分成两组,每组56例,其中对照组围手术期行常规护理,研究组围手术期基于对照组予以优质护理。对比两组并发症发生率、护理总满意度以及干预前后生活质量[生活质量综合评定问卷-74(GQOLI-74)]、自我效能感[自我效能感量表(GSES)]、心理状况[抑郁自评量表(SDS)与焦虑自评量表(SAS)]变化。结果研究组并发症发生率低于对照组(P<0.05)。干预后,研究组SDS分值、SAS分值均低于对照组,GQOLI-74分值、GSES分值均高于对照组(P<0.05)。研究组护理总满意度高于对照组(P<0.05)。结论经导管行二尖瓣成形术围手术期予以优质护理,可降低并发症发生风险,改善心理状态、自我效能感以及生活质量,提高护理总满意度。

Clinical experience of percutaneous m itralballoon valvuloplastyin 350 casesin Chinese and long term follow-up

Objectives: This study is to introduce of the clinical experience of percutaneous mitral balloon valvuloplasty 350 cases in Chinese and the long term follow up. Method: The modfied Inoue method was performed. Results: Effective PBMV was performed in 344 cases, the success rate was 98.3%:mitral area assessed by 2 dimenrional echocardiography (1.11±0.29 to 2.19 ±0.40cm 2, P <0.01 ). One hundrad and five patients were followed at a mean (46.7± 26.3 ) months (range 9 months to 8.5 years). after procedure restenosis was 11.4%(12/15), death 2.9 %(3/105, cerebral embolism in 2, congestive heart failure in 1; mitral valve replacement in 3.8%(4/105). Conclusions: percutaneous mitral commissurotomy provided excellent immediate and lale clinical results.

Mitral Valve Commissurotomy: Which One between the Three Techniques Gives a Better Long-Team Outcome?

Objective: we sought to compare long-term results of three techniques: CMC, OMC and PMC in patients with rheumatic mitral stenosis. Patients and Method: Between January 1994 and December 2015, 183 patients underwent mitral valve surgery for rheumatic mitral restenosis. All patients were investigated by echocardiography-Doppler performed by a senior cardiologist. The patients were divided into 3 groups: patients who have previously closed mitral commissurotomy (CMC n = 101), patients with previously open mitral commissurotomy (OMC n = 28) and those treated by Balloon mitral valvuloplasty (PMC = 54). Results: The three groups were comparable in term of major demographic data. Mitral restenosis occurred precociously in groups treated by PMC (7 ± 4 years), followed by group with OMC 11.4 ± 4 years and CMC group but it occurred later CMC 16.8 ± 7.8 years (p Conclusion: CMC produces better long-term outcome than OMC and PMC. However, it would be premature to conclude to its superiority.

微创三尖瓣成形术与置换术治疗二尖瓣置换术后三尖瓣关闭不全的效果比较

目的探讨微创三尖瓣成形术与置换术治疗二尖瓣置换术后三尖瓣关闭不全的效果。方法选取河南省胸科医院2014年1月至2021年10月收治的50例二尖瓣机械瓣置换术后三尖瓣关闭不全患者,按照治疗方式分为三尖瓣置换术组(8例,接受三尖瓣瓣膜置换术)和三尖瓣成形术组(42例,接受三尖瓣成形术)。比较两组患者手术相关指标、心功能情况以及反流情况。结果三尖瓣成形术组术后体外循环时间、呼吸机使用时间及ICU滞留时间较三尖瓣置换术组短,术后24 h引流量与三尖瓣置换术组相比较少(P<0.05);两组手术时间比较差异无统计学意义(P>0.05);术后6个月,三尖瓣成形术组心功能恢复至Ⅰ级8例,Ⅱ级30例,Ⅲ级4例。三尖瓣成形术组心功能优于三尖瓣置换术组(P<0.05);随访6个月,三尖瓣成形术组三尖瓣轻度反流情况优于三尖瓣置换术组(P<0.05)。结论微创三尖瓣成形术是一种相对简单并安全的手术方式,可改善患者心功能,可作为二尖瓣机械瓣膜置换术后远期出现三尖瓣重度关闭不全的推荐治疗方式。

二尖瓣成形术与二尖瓣置换术在风湿性二尖瓣瓣膜病变治疗中的疗效分析

目的分析风湿性二尖瓣瓣膜病变应用二尖瓣成形术及二尖瓣置换术的效果。方法回顾性分析2018年1月—2022年1月吉林省人民医院收治的58例风湿性二尖瓣瓣膜病变患者的临床资料,按照治疗方法分为对照组(n=29,二尖瓣置换术治疗)和观察组(n=29,二尖瓣形成术治疗),对比两组手术指标、心功能指标、二尖瓣反流情况及术后并发症发生率。结果观察组手术时间、体外循环时间、术中出血量、住院时间优于对照组,差异有统计学意义(P<0.05)。治疗后,观察组患者的LVEF、LVEDD高于对照组,LVESD、LAD低于对照组,差异有统计学意义(P<0.05)。观察组并发症发生率为13.79%,低于对照组的48.28%,差异有统计学意义(χ^(2)=8.056,P=0.005)。结论二尖瓣成形术在风湿性二尖瓣瓣膜病变治疗中的疗效更理想,值得在临床治疗中推广应用。