二尖瓣后叶矩形切除术在二尖瓣成形中的运用

目的 总结二尖瓣后叶矩形切除术的手术方法和临床效果.方法 对62例各种病因导致二尖瓣后叶脱垂伴关闭不全患者行二尖瓣后叶矩形切除、人工瓣环植入术.术中通过注水试验、经食管超声检查成形效果,术后通过心功能改善情况和心脏彩超复查结果来判断二尖瓣成形手术的效果.结果 全组无死亡,术中注水试验效果良好,经食管超声心动图检查二尖瓣反流消失或微量反流.术后平均随访14.5个月(6～24个月),左心房、左心室径缩小(P＜0.05),二尖瓣反流0～Ⅰ级27例,Ⅱ级32例,Ⅲ级3例,无明显收缩期前向移动.心功能Ⅰ～Ⅱ级58例,Ⅱ～Ⅲ级4例.无患者再次行二尖瓣置换术.结论 二尖瓣后叶矩形切除术是治疗二尖瓣后叶脱垂的首选手术方法,掌握正确的手术方法,结合术中多次注水试验及经食管超声心动图检查成形效果,可以取得较好的手术效果.

Application of quadrangular resection technique in mitral valve repair

Objective To evaluate the operative methods and effectiveness of quadrangular resection technique for mitral valve repair.Methods From March 2006 to March 2008,62 patients underwent quadrangular resection technique for mitral valve repair.The surgery consisted of quadrangular resection of posterior mitral valve leaflet and prosthetic valve ring implantation.The results were evaluated by saline injection test and transesophagea echocardiography.Results There was no perioperative death in the 62 patients.Duri...