先天性二尖瓣关闭不全的解剖特点和外科矫正

总结先天性二尖瓣关闭不全１０３例，单纯关闭不全１８例，合并其它先天性心血管病者８５例。４０例为腱索病变，６３例为瓣叶病变，大部分合并不同程度的瓣环扩大。行腱索成形１８例次，瓣叶成形４８例次，瓣环成形３４例次；行二尖瓣替换１７例。成形者中４９例完全矫正，３３例基本矫正，４例成形失败。作者认为，采用腱索、瓣叶和瓣环综合成形的方法，大部分先天性二尖瓣关闭不全均可矫正，部分无法成形者可选择完全保留瓣叶和瓣下结构，行瓣中瓣二尖瓣置入术。

Anatomical Characteristics and Surgical Correction of Congenital Mitral Insufficiency

Aim:Congenital mitral insufficiency maybe surgually treated but sometimes,it can also present a challenge to the cardiac surgeon.This paper is to summarize the experience of surgical treatment of this congenital anomaly.Materials and Method:In this series of 103 cascs,mitral insufficiency existed as isolated congenital anomaly in 18 and as a co existing one in 85.The congenital abnormality was confined to the chordae tendineae in 40 cases and to the mitral leaflet in 63.Annulay dilatation of mitral valve were present in most of the cases.The repair of mitral chordae tendineae was performed in 18 cases,repair of mitral leaflet in 48,mitral annuloplasty in 34 and mitral valve replacement in 17 of which failure of repair in 4 was immediately followed by valve replacement.It is concluded that complete repair of congenital mitral insufficiency is possible in the majority of cases.When the repair failed,intravalve implantation of mitral prosthesis can be done.