ePTFE人工腱索二尖瓣成形术

本文介绍了用ePTFE缝线作人工腱索行二尖瓣成形术 14例的体会。 14例中用ePTFE缝线作人工腱索 17根 ,二尖瓣成形主要有四种方法 :瓣叶部分切除、切缘缝合 ,然后再在瓣缘和乳头肌间建立人工腱索。二尖瓣裂隙伴卷曲瓣叶的人工腱索重建。大瓣部分切除、自体心包片修补瓣叶后 ,人工腱索重建。瓣叶矩形切除、瓣环Kay成形术。结果 ,因持续性Hb尿再次手术行二尖瓣置换和晚期死亡各 1例 ,其余患者术后恢复满意。作者认为只要正确选择病例 ,用ePTFE缝线作人工腱索行二尖瓣成形术是安全有效的

Mitral Valve Repair with Chordal Replacement with Expanded Polytetrafluoroethylene Sutures

Fourteen cases of mitral valve repair with chordal replacement with expanded polytetrafluoroethylene (ePTFE) sutures are intruduced in the article.In the 14 cases of mitral valve repair with 17 ePTFE sutures(34 artifical chordae),there are four methods to repair the mitral valve:(1)the artifical chordae established between the valvular margin and the papillary muscle head after the partial valve removed and then sutured;(2)the cleft and coiled mitral valve repaired with ePTFE sutures;(3)the partial anterior leaflet removed and repaired with autopericardium,and then artifical chordae insertion;(4)the Kay mitral annuloplasty and chordal replacement with ePTFE sutures.All patients are doing well postoperatively except two cases,one undergoing reoperation to replace the mitral valve at the fourth postoperative day because of the severe hemolysis and one died of uncontrolled sepsis.During the follow up time of 5 25 months,there was only one occurred mild mitral regurgitation in the 18th postoperative month.If the indication and the operaitve technique are correct,the mitral valve repair with ePTFE sutures as artifical chordae is effective and safe because of no severe complications related with mitral valve replacement.