后环缝缩矫正二尖瓣关闭不全

目的总结二尖瓣后环缝缩治疗二尖瓣关闭不全（ＭＩ）的临床经验。方法回顾近１０年采用后瓣环缝缩成形治疗ＭＩ的３５例,其中２７例合并先天性畸形,轻度ＭＩ３例,中度ＭＩ２４例,重度ＭＩ８例。全后瓣环缝缩７例,部分后瓣环缝缩２８例,同时行腱索成形７例,瓣叶成形１４例。结果全组无手术死亡。２１例（６００％）完成纠正ＭＩ,１１例（３１４％）基本纠正,３例（８６％）仍轻中度ＭＩ。随访３个月～１０年,３４例心功能Ｉ级,１例术后５年因肺动脉高压死于右心衰。结论二尖瓣后环缝缩是一种简单、安全和有效的瓣环成形方法

Correction of mitral insufficiency with posterior annuloplasty

Objective To summarize the experience in treating mitral insufficiency (MI), due to secondary annular dilation in the posterior portion of the annulus with mitral valve reconstruction. Method Over the past 10 years,we performed mitral valvuloplasty with posterior annuloplasty in 35 patients, of which 27 patients were associated with congenital abnormalities,3 patients had mild MI,24 had moderate MI, and 8 had severe MI.Entire posterior annular plication was performed in 7 patients and partial posterior annular plicatin in 28. Associated subvalvulopasty was performed in 7 patients and leaflets repair reconstruction in 14 . Result There was no postoperative mortality.Complete correction was achieved in 21 patients (60.0%) and partial correction in 11 (31.4%). Mild and moderate insufficiency was found in 3 patients (8.6%) postoperatively.NYHA function class I was gained in 34 patients.One patient developed pulmonary hypertention and died due to right heart failure five years after operation. Conclusion The results indicate that posterior annuloplasty is a safe,effective technique.