超声评价不同二尖瓣置换术式对左心室结构及收缩功能的影响

目的 应用超声评价不同二尖瓣置换术式对左心室结构和功能变化的影响。方法 回顾性分析2008~2010年我院以二尖瓣反流为主的二尖瓣置换术病例76例，其中术中未保留瓣下结构26例，术中仅保留二尖瓣后瓣及瓣下结构30例，保留全部二尖瓣瓣下结构20例。分析患者术前、术后1周及术后3~6个月超声心动图检查左心室功能结果。结果 部分和全部保留瓣下结构组术后左心室舒张末期内径（LVEDD）、左心室收缩末期内径（LVESD）、左心室射血分数（LVEF）及左心室短轴缩短率（LVFS）的改善优于全切组（P＜0.05）；全部保留瓣下结构组术后的改善优于部分保留瓣下结构组（P＜0.05）；但部分和全部保留瓣下结构组术后LVEF、LVFS差异无统计学意义。结论 不同二尖瓣置换术式对左心室结构及收缩功能的影响不同，保留瓣下结构更有利于左心室正常结构及收缩功能的恢复。

Assessment of left ventricular geometry and function by echocardiography before and after mitral valve replacement with and without chordal preservation

Objective To investigate the changes of left ventricular function before and after mitral valve replacement(MVR) with and without chordal preservation.Methods A total of 76 patients with MVR at our institution from 2008 to 2010 were enrolled and were performed by various techniques of choral preservation.Of them,26 had complete excision of the subvalvular apparatus (group A),30 had preservation of the posterior chordopapillary apparatus only (group B),and the other 20 had total chordal preservation (group C...