二尖瓣成形术治疗先天性心脏病合并二尖瓣关闭不全  

Mitral valvoplasty of congenital heart disease with mitral valve regurgitation

作　　者：包阳[1] 徐志云[2] 韩林[2] 陆方林[2] 徐激斌[2] 邹良建[2] 

机构地区：[1]江苏省扬州市第一人民医院心胸外科,江苏扬州225009 [2]第二军医大学附属长海医院胸心外科,上海200433

出　　处：《实用临床医药杂志》2011年第24期75-77,共3页Journal of Clinical Medicine in Practice

摘　　要：目的总结二尖瓣成形术在合并二尖瓣关闭不全的先天性心脏病中的应用经验,并探讨影响疗效的相关因素。方法对本院收治的合并有二尖瓣关闭不全的先天性心脏病患者147例,分别采用瓣膜裂隙修补、交界环缩、瓣环环缩、人工环成形、人工腱索、腱索延长等方法行成形术,39例(26.5%)同时运用2种以上成形技术。结果术后早期死亡6例(4.1%),术后7个月死亡1例。死亡与手术年龄(≤12岁)、体外循环时间(≥120 min)、主动脉阻断时间(≥80 min)及合并心脏畸形有关。随访结果为2例因二尖瓣反流再发,分别于术后半年和1年行二尖瓣置换术。其余病例术后心功能有不同程度改善,超声心动图检查术后瞬时反流量显著低于术前。结论二尖瓣成形术治疗先天性心脏病合并的二尖瓣关闭不全早、中期疗效满意。Objective To summarize the experience of mitral valvoplasty in patients with congenital heart disease with mitral valve regurgitation. Methods 147 patients with congenital heart disease with mitral valve regurgitation underwent valve repair. Isolated mitral valve regurgita- tion was found in 6 patients. The methods of repair included closure of cleft of the mitral leaflet, partial annuloplasty, commissure plication annuloplasty, ring annuloplasty, artificial chordae and chordae prolongation. The associated cardiac anomalies were corrected simultaneously. Results There were 6 hospital deaths （the hospital mortality was 4.1% ） and one late death in patients who underwent mitral valvoplasty. Postoperatively the echocardiography color Doppler study demonstrat- ed a significantly lower regurgitation grade. The NYHA functional class was significantly improved. Reoperation was performed in 2 ~atients. They underwent mitral valve replacement because of resid- ual mitral valve regurgitation. Conclusion Mitral valvoplasty for patients with congenital heart dis- ease with mitral valve regurgitation yields acceptable early mortality and reopration rates.

关 键 词：心脏疾病 先天性 二尖瓣关闭不全 二尖瓣成形术 

分 类 号：R654.2[医药卫生—外科学]