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部分或全部保留瓣下结构的二尖瓣置换术对巨大左室几何学的影响
引用本文:张春曦,黄达德. 部分或全部保留瓣下结构的二尖瓣置换术对巨大左室几何学的影响[J]. 岭南心血管病杂志, 2003, 9(6): 387-389
作者姓名:张春曦  黄达德
作者单位:510180,广州市,广州市第一人民医院心胸外科;510180,广州市,广州市第一人民医院心胸外科
摘    要:目的 动态观察二尖瓣置换术(Mitral valve replacement,MVR)后巨大左心室的几何学变化,对比3种不同术式对左心室形态学逆转的影响。方法 回顾性分析1992年1月至2002年1月间48例巨大左心室病人施行二尖瓣置换术后的超声心动图随访资料。结果 保留二尖瓣装置对巨大左心室形态的逆转有效,其中保留全部瓣下结构术后左窒缩小最显,部分保留其次,无保留术后早期缩小晚期再扩大。结论 对于二尖瓣关闭不全为主合并巨大左室。应尽量采用保留瓣下结构的术式,有利于术后晚期左心室形态的逆转。

关 键 词:二尖瓣关闭不全  二尖瓣置换术  巨大左心室

Giant left ventricular geometry change after mitral valve replacement with complete or partial preservation of subvalve apparatus
ZHANG Chunxi,HUANG Dade. Giant left ventricular geometry change after mitral valve replacement with complete or partial preservation of subvalve apparatus[J]. South China Journal of Cardiovascular Diseases, 2003, 9(6): 387-389
Authors:ZHANG Chunxi  HUANG Dade
Affiliation:ZHANG Chunxi,HUANG Dade. Department of Cardiothoracic Surgery,First Municipal Hospital of Guangzhou city,Guangzhou 510180
Abstract:Objectives To observe the dynamic change of left ventricular geometry after mitral valve replacement (MVR) in patient with giant left ventricle (GLV), and compare the differences of left ventricular geometry reverse among mitral valve replacement with complete preservation of subvalvular apparatus (C-MVR),preservation of posterior leaflet subvalvular apparatus(P-MVR) and no preservation of subvalvular apparatus(N-MVR). Methods The echocardiographic follow-up data of 48 patients with GLV undergoing MVR between Jan 1992 and Jan 2002 were analyzed retrospectively. Results The conservation of subvalvular apparatus during mitral valve replacement was beneficial to the giant left ventricle reversed of geometry, C-MVR confers a significant advantage by reducing left ventricular chamber size compared with P-MVR and N-MVR. In contrast, a tendency of gradually expand in the late stage of postoperation was observed in the N-MVR group. Conclusions Preservation of subvalvular apparatus during MVR are in favor of left ventricular geometry reverse for patients with GLV duo to severe chronic mitral regurgitation.
Keywords:Mitral valve regurgitation  Mitral valve replacement  Left ventricle giant
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