二尖瓣脱垂并关闭不全的外科修补

目的：总结二尖瓣脱垂的外科修复经验，方法：对44例二尖脱垂患者的临床资料进行回顾分析。44例患者中风湿性2例，非风湿性42例（22例合并先天性心脏病），关不全中度24例，重度20例，腱索断裂或缺如12例，腱索过长32例，其中多根腱索过长6例，治疗行腱索移植10例，健索缩短25例（多根腱索短6例），人工腱索1例，瓣叶折叠3例，瓣叶切除5例，同时行瓣裂缝合8例，瓣环成形28例（后环缝缩14例），结果：结果：全组无手术死亡病例，1例风湿性患者术后1个月发生左心房血栓再次手术行瓣膜替换，二尖瓣功能正常34例（77．8％），基本正常6（13．6％），残留轻至中度关闭不全3例（6．8％），随访1－18例（平均6．5年），效果良好，结论：外科修复治疗二尖瓣脱垂是一种安全有效的手术方法。

Surgical repair of mitral valve prolapse with valve regurgitation

Objective To review the experience in surgical repair of mitralvalve prolapse with valve regurgitation. Methods From January 1981 to June 1998， 44 patients with mitral valve prolapse were treated. Among them, 2 had rheumatic valve disease, 20 mitral valve prolapse, and 22 congenital heart disease combined with mitral prolapse. All the patients had mitral valve regurgitation (moderate 24, severe 20). Chordae rupture or absence was observed in 12 patients and chordae elongation in 32. Chordae transplantation was performed in 10 patients. Elongated chordae was shortened in 25 patients and milti-chordae shortened in 6. Artificial chordae was reconstructed in one patient. Concomitant procedures included mitral leaflet removal (5 patients), leaflet plication (3), closure of mitral cleft(8), and anuloplasty (28). Results There no operative mortality occurred. Follow-up averaged 6.5 years (range 1-18 years). In 34 patients (77.8%), mitral function was normal. Slight and mild-moderate regurgitation were noted in 6 and 3 patients respectively. In one of the patients, mitral valve replacement was done again because of left atrial embolism after operation one month. Conclusion Surgical repair of mitral valve prolapse is safe and efficacous.