二尖瓣修复术治疗左室功能减退的二尖瓣 关闭不全患者效果的随访观察(PDF)
《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]
- 期数:
- 2008年第6期
- 页码:
- 776-779
- 栏目:
- 临床研究
- 出版日期:
- 2008-12-25
文章信息/Info
- Title:
- Followup observation of mitral valve repair in treatment of mitral regurgitation with depressed left ventricular function
- Author(s):
- QIU Zhibing; CHEN Xin; XU Ming; SHI Kaihu; JIANG Yingshuo; WANG Liming; XIAO Liqiong; ZHANG Yangbo
- Department of Thoracic & Cardiovascular Surgery, Nanjing First Hospital Affiliated to Nanjing Medical University, Nanjing 210006, Jiangsu, China
- 分类号:
- R654.2
- DOI:
- -
- 文献标识码:
- A
- 摘要:
- 目的 探讨二尖瓣修复术(MVr)对左室功能减退的二尖瓣关闭不全(MR)患者的治疗效果。方法 回顾性分析近9年来 62例中重度MR并发左室功能减退患者的临床资料、手术方法和超声心动图围术期观察及术后随访对比。结果 全组无手术死亡，术后无重大并发症；随访(58±13)月，晚期死亡2例（3%）；失访7例，随访患者恢复心功能Ⅰ级29例(53%)，Ⅱ级26例(47%)；1年后复查49例超声心动图结果显示二尖瓣返流0~轻微36例(73%)，轻度10例(20%)、轻～中度3例(7%)，术后2周、1年心脏超声观察左室舒张末期直径（LVEDD）、左室收缩末期直径（LVESD）及左房直径（LAD）较术前明显缩小，左室射血分数（LVEF）及短轴缩短率（LVFS）明显改善(P<0.05）。结论 二尖瓣修复术，对于并发左心功能不全患者，有利于术后心功能的恢复和改善。
- Abstract:
- AIM To evaluate the therapeutic effects of mitral valve repair (MVr) in patients with mitral regurgitation (MR) and left ventricular dysfunction. METHODS Patients with moderatesevere MR in the latest 9 years were followed up, clinical data, operation methods, echocardiography during operation and postoperative were retrospectively reviewed and the results of ultrosonic cardiogram (UCG) were comparatively analyzed. RESULTS There were no operative or postoperative earlyterm death and no postoperative severe complications. A total of 62 patients were identified with a mean followup of 58±13 months. There were two late death（3%）. Seven patients were lost in followup. In recorded cases, 29 patients (53%) had NYHA functional classⅠand 26 survivors (47%) showed the class Ⅱ. UCG showed no or only trace mitral regurgitation in 36 cases(73%), mild MR in 10(20%) and mildmoderate MR in 3 (7%) cases of the 49 patients one year postoperatively. The value of LVEDD, LVESD and LAD 2 weeks and one year postoperatively was much more decreased than those before operation（P<0.05）. The value of LVEF and FS 2 weeks and 2 months after operation was more increased than those before operation（P<0.05）. CONCLUSION Mitral valve repair is favorable to the recovery and improvement of the heart function after operation, especially for MR patients with left ventricular dysfunction.
参考文献/References
［1］ David TE, Ivanov J, Armstrong S, et al. Late outcomes of mitral valve repair for floppy valves: implications for asymptomatic patients［J］. J Thorac Cardiovasc Surg, 2003, 125(5):1143-1152.
［2］ Kouris N,Ikonomidis I,Kontogianni D, et al. Mitral valve repair versus replacement for isolated nonischemic mitral regurgitation in patients with preoperative left ventricular dysfunction. A longterm followup echocardiography study［J］. Eur J Echocardiogr, 2005, 6(6):435-442.
［3］ Gogbashian A, Sepic J, Soltesz EG, et al. Operative and longterm survival of elderly is significantly improved by mitral valve repair［J］. Am Heart J, 2006, 151(6):1325-1333.
［4］ 杨阳，杨新莉. 心房颤动的易发因素及其机制研究［J］. 心脏杂志， 2005， 17(5)：493-494.
［5］ Kim YH, Czer LS, Soukiasian HJ, et al. Ischemic mitral regurgitation: revascularization along versus revascularization and mitral valve repair［J］. Ann Thorac Surg, 2005, 79(6):1895-1901.
［6］ Zalaquett R, Campla C, Cordova S, et al. ［Longterm results of repair surgery of degenerative mitral insufficiency］［J］. Rev Med Chil, 2003, 131(12):1355-1364.
［7］ 汪朝阳，张志梁，邵国丰，等. 风湿性心脏病并发心源性恶液质的外科治疗［J］. 心脏杂志， 2005， 17(5)：503.
［8］ Calafiore AM, Di Mauro M, ActisDato G, et al. Longitudinal placation of the posterior leaflet in myomatous disease of the mitral valve［J］. Ann Thorac Surg, 2006, 81(6):1909-1910.
［9］ Winters M, Obriot P. Mitral valve repair［J］. AORN J, 2007, 85(1):152-166.
［10］Walkes JC, Reardon MJ. Status of mitral valve surgery［J］. Curr Opin Cardiol, 2004, 19(2):117-122.
备注/Memo
- 备注/Memo:
- 收稿日期：2007-07-16.基金项目：江苏省社会发展基金项目资助(BS2006013) 作者简介：邱志兵，主治医师，硕士Email：qiuzhibingjs＠yahoo.com.cn
常用功能
统计/Statistics
- 摘要浏览/Viewed1271
- 全文下载/Downloads862
- 评论/Comments
