心脏瓣膜创伤的诊断和手术治疗

目的：总结心脏瓣膜创伤的诊断和手术治疗经验，方法：对4例心脏瓣膜创伤的临床资料进行回顾性分析。结果：二尖瓣前叶乳头肌断裂伴瓣叶穿孔行二尖瓣置换术1例。主动脉瓣穿孔伴关闭不全行主动脉瓣置换术1例，三尖瓣前叶撕裂1例，用自体心包做瓣叶修补术及三尖瓣环De Vega 成形术。三尖瓣隔瓣腱索断裂伴创伤性室缺1例，行三尖瓣修复成形术及室缺修补术，4例患者手术疗效满意。结论：心脏瓣膜创伤应尽早进行瓣膜置换术或瓣膜修复成形术，能取得优良效果。

Diagnosis and surgical treatment of cardiac valve injury

Objective To summarize the experience of diagnosis and surgical treatment of cardiac valve injury. Methods Clinical materials of heart valve injury in 4 cases were analyzed retrospectively. Results One case who presented rupture of anterior papillary muscle and tear of the anterior leaflet in mitral valve was cured with mitral valve replacement. In one case with aortic valve rupture, the aortic valve replacement was performed. Of two cases with tricuspid valve injury, one with dehiscence of anterior leaflet in tricuspid valve from the annulus was treated by valve repair with a patch of pericardial autograft plus a De Vega annuloplasty; the other with chordal disruption of septal leaflet in tricuspid valve and traumatic VSD was cured with a leaflet plication in the region of disruption plus a repair of VSD. The surgical results in all 4 cases proved to be quite satisfactory. Conclusions The cardiac valve replacement and repairshould be performed as early as possible and an excellent effect can be obtained.