上海交通大学学报（医学版）

上海交通大学学报（医学版）

• 论著（临床研究） • 上一篇    下一篇

应用复合二尖瓣成形技术治疗复杂性二尖瓣关闭不全的效果研究

马文锐，张卫，叶伟，石暐   

  1. 上海交通大学附属胸科医院心血管外科， 上海 200030
  • 出版日期:2016-03-28 发布日期:2017-06-02
  • 通讯作者: 张卫, 电子信箱: zhangwyyy@citiz.net。
  • 作者简介:马文锐（1992—）， 男， 硕士生; 电子信箱: hverliebt@icloud.com。

Study on the efficacy of combined mitral valve repair techniques in treating complex mitral insufficiency

MA Wen-rui, ZHANG Wei, YE Wei, SHI Wei   

  1. Department of Cardiovascular Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai 200030, China
  • Online:2016-03-28 Published:2017-06-02

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摘要：

目的 研究应用多种二尖瓣成形技术于同一患者对复杂性二尖瓣关闭不全的纠治效果。方法 对患有中度以上复杂性二尖瓣关闭不全的76例患者，复合应用两种及以上成形技术进行纠治。术中行经食管超声心动图（TEE）检测二尖瓣关闭情况；术后出院前行心脏彩色超声复测瓣膜反流情况；随访近中期二尖瓣关闭情况及左心功能相关参数。结果 术中TEE检测结果提示，应用复合二尖瓣成形技术后二尖瓣关闭优良率达9737%（74/76）。出院前心脏彩色超声结果与术中TEE结果相同。随访6～72个月，二尖瓣关闭优良率达9342%（71/76），左室射血分数较术前明显提高，左室舒张末内径较术前明显缩短。 结论 复合应用多种二尖瓣成形技术是纠治复杂性二尖瓣关闭不全的有效方法，所复合术式的选择视患者瓣膜的病变情况与术者对各种技术的熟练掌握程度而定。

关键词: 复合二尖瓣成形技术；复杂性二尖瓣关闭不全, 疗效

Abstract:

Objective To investigate the therapeutic efficacy of using multiple mitral valve repair techniques in treating patients with complex mitral insufficiency. Methods Two or more repair techniques were used for treating 76 patients with moderate or severe mitral regurgitation. The closure of mitral valve was examined perioperatively by transesophageal echocardiography (TEE) and valve regurgitation was examined by transthoracic echocardiography (TTE) before discharge. The closure of mitral valve and relevant left heart parameters in short and medium terms were followed up. Results The perioperative TEE results showed that the closure of mitral valve in 9737% (74/76) of patients reached satisfactory outcome after using combined repair techniques. TTE results before discharge were consistent with TEE results. 6-72 months of followup showed that the closure of mitral valve in 9342% (71/76) of patients reached satisfactory outcome with significant higher left ventricular ejection fractions and lower left ventricular end diastolic diameters compared with preoperative data. Conclusion Combined mitral valve repair techniques are efficient for treating complex mitral insufficiency and the choice of combined surgical procedure should be based on pathological changes in patient valves and surgeons mastery of repair techniques.

Key words: combined mitral valve repair, complex mitral insufficiency, therapeutic effect