二尖瓣狭窄球囊扩张术前、后肺静脉血流和左房压力的关系

目的： 探讨定量评估左房压力和左室舒张功能的新途径。方法： 利用经胸多普勒超声测量１５例窦性心律风心病二尖瓣狭窄患者在二尖瓣球囊扩张术（ＰＢＭＶ） 前、后的肺静脉血流, 并与ＰＢＭＶ术前、后的左房压力对比。结果： １、成功的ＰＢＭＶ术后, 立即引起窦性心律患者肺静脉收缩血流的增加。收缩期血流峰值（Ｓ） 从４３．９１±７．６９ｃｍ ／ｓ增至５０．９７±１０．０９ｃｍ ／ｓ, Ｐ＜ ０．００２。收缩期血流速度时间积分 （ＳＶＴＩ） 从７．８８±３．１７ｃｍ 增至９．８５±３．１３ｃｍ , Ｐ＜ ０．００１。２．左房压力和肺静脉血流有良好的相关性。左房压力和收缩分数（ＳＦ＝ ＳＶＴＩ／ＳＶＴＩ＋ ＤＶＴＩ） 相关性最好为ｒ＝ － ０．７１, Ｐ＜ ０．０５。结论： 肺静脉血流可以评估左房压力。即ＳＦ％ ＜ ５０％ 时, 左房压力＞ １８ｍ ｍ Ｈｇ。     

超声心动图评价二尖瓣环成形术中应用三种不同人工瓣环后的中期疗效

目的　超声心动图评价二尖瓣环成形术中应用三种不同人工瓣环的中期疗效 ,为临床上合理选用人工二尖瓣环提供参考。方法　心外科施行二尖瓣成形术中植入Carpentier硬环、Duran闭合环、Cosgrove开放软环的 69例患者 ,Carpentier环组 (CA组 ) 19例 ,Duran环组 (DU组 ) 2 8例 ,Cosgrove环组(CO组 ) 2 2例 ,均为二尖瓣关闭不全患者。记录所有患者术前、术后二维超声心动图资料 ,包括二尖瓣反流程度、二尖瓣跨瓣压差、跨瓣最大流速、二尖瓣环收缩末和舒张末横径、二尖瓣环收缩末和舒张末纵径、左室射血分数、左房内径、肺动脉收缩压、左室收缩末容积、左室舒张末容积、室壁增厚率 (ΔT %)。 15例患者术后随访实时三维超声心动图 ,包括二尖瓣环舒张末、收缩末面积和面积变化率。结果　共随访到 68例患者 ,随访率 98.5 %,平均随访时间为 (9.3± 7.4)个月。术后三组二尖瓣反流程度均较术前显著下降(P <0 .0 0 1) ,二尖瓣跨瓣压差及二尖瓣血流速度较术前升高 (P <0 .0 5 ,P <0 .0 0 1) ,二尖瓣环直径均较术前明显缩短 (P <0 .0 5 )。术后人工二尖瓣环收缩末与舒张末直径变化率比较 ,横径CA组小于其他两组 ,纵径CA组小于DU组 ,DU组小于CO组 (均P <0 .0 5 )。实时三维超声检测二尖瓣环面积变化率 ,CA组小于其他两组     

彩色多普勒超声评价自制无支架带腱索生物二尖瓣功能

目的 评价自制无支架带腱索生物二尖瓣的临床应用效果。为无支架带腱索生物二尖瓣的推广应用提供理论依据。方法 用彩色多普勒超声心动图观察3例无支架带腱索生物二尖瓣替换术后心脏结构及血流动力学变化。结果 胸骨旁四腔心及左室短轴观极易观察到生物二尖瓣叶启闭运动，二尖瓣病变患者术后左房内径均较术前明显缩小，二尖瓣均无关闭不全‘；舒张期跨二尖瓣口峰值血流速度，平均血流速度，血流速度积分，峰值压差，平均压差和压力降半时间较术前明显改善，有效瓣口面积增加，但与自然瓣膜相比仍有差距。结论 无支架带腱索生物二尖瓣可维持人体二尖瓣生理功能，左室几何形状和血流动力学，彩色多普勒超声心动图在评价无支架带腱索生物二尖瓣替换术后的心脏结构和血流动力学方面有着较大的临床意义及实用价值。     

组织多普勒评价阵发性心房颤动患者环肺静脉左心房线性消融术后左心房功能变化

目的 利用组织多普勒超声评价阵发性心房颤动(房颤)患者环肺静脉左房线性消融术后左房功能的动态变化.方法 阵发性房颤患者108例,CARTO系统下行环肺静脉左房线性消融术,术前48 h及术后48 h、1个月、3个月、6个月分别行组织多普勒及常规超声心动图检查.结果 106例阵发性房颤患者成功施行环肺静脉左房线性消融术.与术前相比,左房前后径和左房容积减小,但术后48 h、1个月差异无统计学意义(P＞0.05),术后3个月和6个月差异有统计学意义(P＜0.05);左室舒张末内径、左室收缩末内径、左室射血分数差异无统计学意义(P＞0.05);二尖瓣舒张早期峰速差异无统计学意义(P＞0.05),二尖瓣舒张晚期峰速术后48 h较术前降低(P＜0.05),术后1个月、3个月、6个月逐渐增高,3个月时恢复到术前水平.与术前相比,二尖瓣环左室侧壁收缩期峰速、舒张早期峰速差异无统计学意义(P＞0.05),舒张晚期峰速术后48 h较术前降低(P＜0.05),术后1个月、3个月、6个月逐渐增高,1个月时恢复到术前水平.结论 环肺静脉左房线性消融术后左房内径和容积减小;环肺静脉左房线性消融术后可出现左房主动收缩功能降低(左房顿抑),经过一段时间可自行恢复.     

正常Carbo Medics双叶瓣的超声评价

本文对３０例风湿性心瓣膜病人ＣａｒｂｏＭｅｄｉｃｓ（简称ＣＭ）机械双叶瓣置换二尖瓣且ＣＭ瓣功能正常的患者术臆及术后早期进行超声检查，重点是：ＣＭ瓣口的各项多普勒血流参数，术后早期左房容积，左室大小及功能，肺动脉收缩压的改善情况，结果表明：ＣＭ双叶瓣在术后早期功能良好，仅存在轻度血流受阻；术后早期左房容积明显回缩，肺动脉收缩压降低，说明患者心血管系统血流动力学在术后早期即得到改善。     

保留后瓣及瓣下结构与常规二尖瓣替换术的左心功能探讨

对１５例心脏瓣膜病患者采用保留后瓣及瓣下结构的二尖瓣替换术，并与同期或先期采用常规二尖瓣替换术１７例进行了左心功能及超声结果对比研究，前者术后１～３年超声检查显示；人造瓣膜启闭速度加快，室间隔矛盾运动消失，室壁动度增强，房颤大多消失，左心功能ＥＦ、ＦＳ、ＳＶ、ＣＯ、ＥＤＶＩ、ＥＳＶＩ、ＳＶＩ、ＣＩ较常规二尖瓣替换术恢复更佳，作者对保留后瓣及瓣下结构的临床意义和适应症的选择进行了讨论。     

经导管线性消融术治疗阵发性房颤对左房近期功能的影响

目的应用超声心动图评价左房线性消融术治疗阵发性房颤对近期左房功能的影响。 方法28例因阵发性房颤行线性消融的患者，于术前和术后2～3个月行超声心动图检查。通过二维超声测量左房容积和排空能力，组织速度成像检测二尖瓣前瓣环舒张晚期峰值速度Va，应变率显像检测左房壁舒张晚期峰值应变率SRa，来观察左房储存功能、管道功能和辅泵功能的变化。 结果消融后左房收缩末容积和左房内径无明显改变；左房管道容积和舒张末容积增高；左房分数、左房射血力、二尖瓣血流VA、二尖瓣环Va显著降低；左房平均SRa和局部各壁SRa均显著降低，尤其以后壁和侧壁降低最明显。 结论线性消融术对近期左房局部和整体功能均存在一定程度的不利影响。     

超声心动图评价心脏再同步化治疗对心力衰竭患者左心室重构逆转的指标选择

目的 利用超声心动图探讨左心室重构逆转参数是否可以成为评价充血性心力衰竭(心衰)患者心脏再同步化治疗(CRT)术后短期疗效的重要指标.方法 对26例心衰伴有室壁运动不协调患者进行CRT治疗,分别于术前及术后1个月、3个月行超声心动图检查,测量舒张末期左房内径(LADD)、左室内径(LVDD)、左室舒张末容积(LVEDV)、左室收缩末容积(LVESV)和左室射血分数(LVEF),比较起搏治疗前后各参数的变化.结果 术后1个月、3个月LADD、LVDD、LVEDV、LVESV均较术前显著减小,LVEF较术前显著提高,差异有统计学意义(P＜0.05).而且这些参数的改善与患者活动度成正比,与夜间心率成反比,其中左房、左室内径及容积变化较LVEF提高与患者心功能改善的相关性更为显著.结论 左室重构逆转参数可以成为评价CRT术后短期疗效的重要指标,其中部分患者左房、左室大小和容积指标较LVEF更为敏感.     

左心房三维重建在二尖瓣成形术中的应用

为观察左心房容量大小在二尖瓣成形术中的作用，应用ＭａｃｉｎｔｏｓｈＥｃｈｏＰＡＣ左室三维重建软件分析系统对二尖瓣成形术患者术前和术后的左房进行三维重建，并测定收缩期和舒张期左房容量。为了解左房容量与左房压、肺动脉压之间的关系，对左房压和肺动脉压与左房容量之间的关系进行了相关分析。结果显示，术前收缩期友房容量为８３．２６±３１．９７ｃｍ￣３，舒张期容量为１３５．７６±５４．２５ｃｍ￣３；术后收缩期容量为５５．４３±１８．８４ｃｍ￣３，舒张期容量为８９．３４±４６．５５ｃｍ￣３。术前、术后收缩期和舒张期容量改变均具极显著的差异。术前左房容量和术前左定压、肺动脉压，术后左房容量与术后左房压、肺动脉压之间无显著性差异。     

动态三维超声心动图评价二尖瓣关闭不全

本文采取经胸壁及经食道旋转扫描方法获取二维数据，利用总体重建法（ＶｏｌｕｍｉｃＲｅｎｄｅｒｉｎｇＤｉｓｐｌａｙ）对１２例正常人二尖瓣，１４例风心病二尖瓣关闭不全，２０例二尖瓣脱垂患者的二尖瓣解剖结构及二尖瓣返流束进行了动态三维超声心动图重建。重建图像能从左室或左房侧显示二尖瓣装置的整体三维空间结构及动态变化。正常二尖瓣叶光滑平软，舒张期瓣口充分开放，收缩期前后叶对合良好。风心病二尖瓣关闭不全患者瓣叶增厚，收缩期前后叶之间出现裂缝。二尖瓣脱垂时瓣叶某一部分呈“瓢匙”样向左房侧脱出。动态三维超声心动图还能显示二尖瓣关闭不全血液返流束的立体形态及在左房内的空间走向。初步经验表明动态三维超声心动图对二尖瓣关闭不全的诊断有重要临床价值     

Detection of prosthetic mitral valve leak: a comparative study using transesophageal echocardiography, transthoracic echocardiography, and auscultation

Paravalvular leakage is a major complication of prosthetic valve dysfunction. Sixty-one subjects with valvular heart disease who had received prosthetic mitral valve replacement 5 months to 5 years before (43 received a porcine prosthesis and 18 received Bjork-Shiley valve prostheses) were evaluated for this complication. Careful auscultation was performed by two experienced cardiologists followed by transthoracic and transesophageal echocardiography. Physiologic leaks were detected in all Bjork-Shiley valves, but in only 30% of porcine valves using transesophageal echocardiography. These regurgitant jets were flame-like, with mean low velocities of 50 +/- 12.3 cm/sec and 48 +/- 18.2 cm/sec in the two types of valves. Neither transthoracic echocardiography nor auscultation could detect physiological regurgitant jets. Ten cases with paravalvular leak were detected by transesophageal echocardiography and subsequently demonstrated by left ventriculography (7 porcine, 3 Bjork-Shiley valves). Pathologic regurgitant jets were seen as high-velocity, systolic-retrograde turbulent flow across the prosthesis. However, only 6 cases of prosthetic valve dysfunction were detected by transthoracic echocardiography, 4 cases of mild paravalvular leakage went undetected. Thirteen of the 61 subjects had an apical systolic murmur and suspected prosthetic valve leakage; in 10 of the 13 cases the findings corresponded to those obtained by transesophageal echocardiography. In 3 cases of double valve replacement with Bjork-Shiley valves the magnitude of the leakage was overestimated by auscultation.     

Transesophageal echo-Doppler echocardiographic assessment of pulmonary venous flow patterns.

Fifty-eight of 61 consecutive patients undergoing transesophageal echo-Doppler echocardiography provided excellent signals to permit assessment of pulmonary venous blood low patterns. Normal antegrade pulmonary venous flow during ventricular systole was biphasic and was characterized by a short, low velocity (28 +/- 17 cm/sec), early systolic jet (P1), and longer, higher velocity (41 +/- 23 cm/sec), late systolic jet (P2). Antegrade pulmonary venous flow during ventricular diastole (P3) was of moderate velocity (34 +/- 17 cm/sec) and was monophasic; during atrial contraction there was transient, low velocity (-17 +/- 11 cm/sec) and reversal of flow (P4). The early systolic antegrade venous flow (P1) was absent or reversed in rhythm disorders, which interrupted normal synchronized atrioventricular activation. These rhythm disorders also were associated with diminished peak flow velocities during late systole (P2). Abnormalities in systolic left ventricular function and mitral regurgitation also had this effect. Diastolic flow velocities (P3) remained constant, except in patients with mitral regurgitation. In these patients diastolic peak flows were significantly increased above normal. In cases of atrial fibrillation or ventricular pacing the late diastolic reversal of flow resulting from atrial contraction (P4) was absent. Conclusions: Transesophageal echo-Doppler echocardiography gives high quality signals of pulmonary venous inflow to help assess function of the left ventricle and left atrium. Multiple factors affect the patterns. This study suggests caution in the interpretation of abnormal patterns, particularly of reduced systolic pulmonary vein flow in the presence of left ventricular dysfunction, atrial fibrillation, ventricular pacing, and mitral regurgitation.     

Measurement of left ventricular dp/dt by simultaneous Doppler echocardiography and cardiac catheterization.

Left ventricular dp/dt is a useful isovolumic index for evaluating acute directional changes in myocardial contractility. To test the hypothesis that Doppler echocardiography can measure left ventricular dp/dt by using the mitral regurgitation velocity curve, 14 patients with at least a mild degree of mitral regurgitation (four with coronary artery disease, four with valvular heart disease, four with dilated cardiomyopathy, one with carcinoid, and one with mitral valve prosthesis) were studied by continuous-wave Doppler echocardiography. Simultaneously, left ventricular pressure was measured with a manometer-tipped catheter to generate actual dp/dt. Curves of left ventricular pressure and mitral regurgitant Doppler-derived velocities of three cardiac cycles were digitized at 1-msec intervals. The rate of Doppler-derived velocity increase was converted to a rate of pressure increase by using the modified Bernoulli equation. Mean dp/dt during various time intervals of the mitral regurgitation velocity envelope (1 to 2 m/sec, 2 to 3 m/sec, and 1 to 3 m/sec) corresponding to left ventricular-left atrial pressure differences of 12, 20, and 32 mm Hg, respectively, were calculated. Doppler-derived left ventricular dp/dt (y) correlated with catheter-derived left ventricular dp/dt (x) as follows: at the 1 to 2 m/sec interval, y (mm Hg/sec) = 0.84x + 137, r = 0.91, SEE = 90; at the 2 to 3 m/sec interval, y = 1.1x - 89, r = 0.96, SEE = 80; and at the 1 to 3 m/sec interval, y = 1.1x + 23, r = 0.98, SEE = 50.(ABSTRACT TRUNCATED AT 250 WORDS)     

评价原位完整保留瓣下结构的二尖瓣替换术

目的 :总结 11例二尖瓣替换术 (MVR)原位保留瓣下结构的方法和技术要点 ;评价其对术后早期左心室收缩、泵血功能的影响 ;探讨潜在的合并症。方法 :部分切除二尖瓣前叶 ,分别将残留前叶及全部腱索和完整后叶及腱索重新缝合、固定在前、后叶原瓣环上。术后 10d应用超声心动技术观测左心室舒张末、收缩末容积指数 (LVEDVI ,LVESVI) ,射血分数 (LVEF) ,峰值排空率 (LVPER)、左心室流出道 (LVOT)收缩期血流速度和残留前叶的前向运动 (SAM )。结果 :本组病例无手术死亡或严重合并症。术后LVEDVI,LVESVI均明显降低 (均为P <0 .0 1) ,LVEF和LVPER明显高于术前 (均为P <0 .0 5 )。收缩期LVOT血流速度无明显加快 ;无SAM现象。结论 :原位保留二尖瓣前、后叶腱索的MVR技术并不复杂 ,易推广。对术后早期左心室收缩、泵血功能具有明显的维护、改善作用。无人工机械瓣膜运动障碍 ;但存在潜在的LVOT梗阻的合并症     

超声心动图观察二尖瓣成形术治疗二尖瓣关闭不全的近期疗效

目的超声心动图结合血流动力学导管监测观察二尖瓣成形术对严重二尖瓣关闭不全的治疗效果及左心功能的影响。方法对30例中一重度二尖瓣关闭不全的患者。于术前及术后早期进行超声心动图检查，成形术前麻醉诱导后及术后12h Swan-Ganz导管监测血流动力学指标。结果术后20例患者经超声心动图检查返流信号完全消失。2例探及中量返流信号；所有患者二尖瓣口开放面积无明显狭窄。左室舒张末期容积、每搏输出量、射血分数及舒张期左房、室间压差降低，E／Em无明显变化；肺循环阻力、肺动脉楔压等降低。结论超声心动图对二尖瓣关闭不全的严重程度的评价及对病因的诊断与外科手术结果吻合，对成形术疗效及手术前后心功能的评判与血流动力学监测基本相符。     

Early diastolic motion of the posterior aortic root as an index of left ventricular filling

Aortic root motion on M-mode echocardiography is related to left atrial volume change. Early diastolic motion of the aortic root has been quantified by the atrial emptying index. This index has been shown by some investigators to assess early diastolic left ventricular filling, while other investigators report conflicting findings. To evaluate further early diastolic motion of the posterior aortic root, we describe a new echocardiographic parameter—the slope of early diastolic posterior aortic root motion. This parameter appears superior to the atrial emptying index in assessing early diastolic left ventricular filling. Forty-one patients were studied by M-mode echocardiography and were divided into group I (17 patients) with diminished E to F mitral value slopes (<70 mm/sec) and group II (24 patients) with normal E to F mitral valve slopes (≥70 mm/sec). Patients in group I and group II had comparable left atrial sizes and left ventricular dimensions. The aortic root slope and normalized aortic root slope (normalized for left atrial dimension) in group I (3.7 ± 1.4 cm/sec and 1.0 ± 0.4 sec^?1, respectively) were significantly less than in group II (6.4 ± 1.4 cm/sec and 1.9 ± 0.6 sec^?1, respectively). The atrial emptying index and atrial emptying index normalized for heart rate were not different between the two groups. When the 41 patients were analyzed according to the presence or absence of left ventricular hypertrophy by echocardiography, only the normalized aortic root slope was significantly different in patients with or without left ventricular hypertrophy. A significant linear correlation (r = 0.84, P < 0.0005) was found between the aortic root slope or normalized aortic root slope and the E to F slope of the mitral valve. Significant correlations also existed between the aortic root slope and the slope of early diastolic left ventricular rapid filling. Therefore, the slope of early diastolic motion of the posterior aortic root appears to be a useful and easily obtainable echocardiographic parameter to assess early diastolic left ventricular filling.     

超声心动图在经导管主动脉瓣置换术前评估与术后随访中的应用价值

目的探讨超声心动图在评估经导管主动脉瓣置换（TAVR）术前与术后心脏结构和功能改变中的应用价值。 方法回顾性选取2014年9月至2019年7月在复旦大学附属中山医院心内科行TAVR的重度主动脉瓣狭窄（SAS）患者47例。所有患者均于术前及术后6个月行经胸超声心动图检查并记录常规超声心动图参数和主动脉瓣相关参数,包括左心室收缩末期内径（LVESD）、左心室舒张末期内径（LVEDD）、室间隔厚度（IVST）、后壁厚度（PWT）、肺动脉收缩压（PASP）、主动脉瓣最大跨瓣压差（AVPGmax）、主动脉瓣平均跨瓣压差（AVPGmean）、主动脉瓣有效瓣口面积（AVA）、左心室射血分数（LVEF）、主动脉根部内径（AORD）、左心房内径（LAD）,分析TAVR术前与术后的超声心动图参数变化。 结果与术前相比,术后47例患者的LVESD、IVST、PWT、PASP、AVPGmax、AVPGmean均明显减小,差异均有统计学意义（P均＜0.05）;AVA和LVEF均明显变大,差异均有统计学意义（P均＜0.05）。术后合并二尖瓣反流中度及以上或三尖瓣反流中度及以上的患者较术前明显减少（8例vs 3例,7例vs 2例）。 结论TAVR可纠正主动脉瓣狭窄,改善患者心功能。超声心动图相关参数有助于TAVR术后人工瓣膜及患者心脏结构功能的随访评估。     

实时三维经食管超声心动图对二尖瓣成形术的指导意义

目的探讨实时三维经食管超声心动图（TEE）在二尖瓣脱垂患者外科手术治疗中对二尖瓣结构精细化诊断、成形环选择的意义及术后即刻疗效评估的价值。 方法选择2016年11月至2017年3月浙江大学附属第一医院经胸超声心动图诊断为二尖瓣脱垂,并进行外科手术治疗的19例患者。19例患者均在麻醉后体外循环之前行实时三维TEE检查。并在手术完成心脏复跳后即刻再次进行检查,实时显示并记录存储图像。整个检查过程中与外科医师、麻醉医师同时观察图像,直接交流并与术中所见相对照,以术中所见为标准。应用实时三维超声重建对19例中度以上二尖瓣脱垂患者进行检查测量,观察二尖瓣瓣膜与腱索,测量二尖瓣的瓣环、瓣膜长度及纤维三角的直径。 结果术中TEE检查可从任意角度清晰显示二尖瓣瓣膜、瓣环、腱索、乳头肌的解剖结构、运动情况。实时观察二尖瓣厚度、活动度、有无钙化及赘生物,腱索有无断裂,并能补充诊断有无血栓及卵圆孔未闭。本组19例患者TEE判断二尖瓣脱垂区域与术中基本一致,以后叶P2区最多见。检出病因：二尖瓣腱索断裂导致脱垂共15例,其中12例探查到2处腱索断裂,与术中一致,准确率100%。本组19例患者TEE测量后提供的成形环尺寸14例一致,准确率73.7%（4/9）,4例术中选择测瓣器size比TEE测值小一号,1例术中选择测瓣器size比TEE测值大一号。 结论应用实时三维超声重建可客观地反映二尖瓣脱垂的病因及病变情况,提供直观的立体图像,对制定手术方案具有重要参考价值。并能为选择成形环的大小提供依据,节约了手术时间,具有实际的临床指导意义。术后即刻评价自体成形瓣膜的功能,并实时了解室壁运动及左心室收缩功能,也可以监测左心气体,有助于麻醉医师术中监护,同时提高了手术的成功率。     

多普勒超声心动图研究硝酸甘油对心肌梗塞患者左心舒缩功能的影响

应用多普勒超声心动图观察舌下含服硝酸甘油对２６例心肌梗塞（ＭＩ）患者左心舒缩功能的影响。结果显示硝酸甘油明显降低ＭＩ患者的左室收缩末容积和舒张末容积；改善和加强ＭＩ患者左室整体收缩功能。ＭＩ患者存在左室舒张期充盈形式异常，表现为Ｅ／Ａ＜１，而二尖瓣口舒张期血流频谱Ｅ／Ａ≥１的７例ＭＩ患者含服硝酸甘油后６例（８５．７％）表现为Ｅ／Ａ＜１，结果提示含服硝酸甘油有助于鉴别二尖瓣血流频谱是真性正常抑或假性正常     

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。