二尖瓣成形术治疗二尖瓣关闭不全临床分析

目的总结68例二尖瓣成形术的临床经验,评估其术后临床效果。方法回顾分析2001年12月-2011年12月进行二尖瓣成形术治疗的68例二尖瓣关闭不全患者的临床资料。成形术的方法为:人工瓣环植入、双孔成形、后瓣矩形切除、赘生物切除及心包补片修复、腱索转移等。术中采用注水实验和经食管超声心动图检查评估成形效果。结果 68例患者中手术死亡2例,二次开胸止血1例,肺部感染3例。全部患者术中注水实验和食管超声心动图检查显示成形效果满意。存活66例患者随访6个月,术后10 d、6个月彩色多普勒超声心动图检查:左心房内径、左心室舒张末内径缩小。术后6个月彩色多普勒超声心动图检查:无或微量反流33例,轻度反流27例,轻～中度反流5例,中度反流1例。结论根据二尖瓣关闭不全的特征,选择相应的二尖瓣成形技术,可以取的较好的临床效果。

Clinical Analysis of Cardio Mitral Valvuloplasty for Improving Mitral Valve Regurgitation

Objective To evaluate the clinical outcomes of mitral valvuloplasty in 68 patients for improving mitral valve regurgitation and heart function.Methods From December 2001 to December 2011,68 patients with mitral valve insufficiency underwent mitral valvuloplasty at our hospital.The operative techniques included annular ring implanting,double orifice repair,quadrangular resection,removal of vegetation,mitral valve repair,and chordal transposition,etc.The results were evaluated by saline injection test and transesophageal echocardiography.Results The surgical mortality was 2.1%(2/68).One patient received reoperation for mediastinal hemorrhage.Three patients had acute pneumonia.Surgical efficiency was satisfactory by saline injection test and transesophageal echocardiography during the operation.The left atrial dimension and left ventricular end-diastolic diameter of all the patients decreased respectively 10 days and 6 months after the operation.Echocardiography evaluation showed no or nuance amount of regurgitation in 33 patients,little amount in 27,little to moderate in 5,and moderate in 1.Conclusion By flexibly utilizing many kinds of mitral valvuloplasty methods,satisfactory surgical repair outcome can be achieved in mitral valve insufficiency patients.