人工腱索置入的二尖瓣置换术5年效果分析  

Five years results of mitral valve replacement with artificial chordae tendineae implantation

作　　者：蔡国华[1] 孙振东[1] 刘石健骢 张庆华[1] 亓峰[1] 吴乃石[1] 刁力为[1] CAI Guohua;SUN Zhendong;LIU Shijiancong;ZHANG Qinghua;QI Feng;WU Naishi;DIAO Liwei(Department of Cardiovascular Surgery,The 2nd affiliated Hospital of Harbin Medical University,Harbin 150086,China)

机构地区：[1]哈尔滨医科大学附属第二医院心外科三病房,150086 [2]中山大学附属第五医院

出　　处：《心肺血管病杂志》2020年第4期424-427,共4页Journal of Cardiovascular and Pulmonary Diseases

基　　金：黑龙江省卫生计划委科研课题资助项目(2016-067)。

摘　　要：目的:评价人工腱索置入的二尖瓣置换术后5年效果。方法:将术后随访>5年的行二尖瓣置换患者分为两组。组1患者二尖瓣置换同时行人工腱索置入;组2二尖瓣置换时保留全部或部分后瓣患者,每组各30例。将术后5年的超声结果进行比较,同时比较术前、术后各组间数据差别。结果:对于二尖瓣替换手术,人工腱索置入与保留瓣下结构患者术后各项指标均有良好的改善,中期效果相当。结论:当二尖瓣置换手术中瓣下结构严重钙化,腱索、乳头肌与瓣膜重度粘连及融合导致其无法保留的风湿性心脏病患者中,人工腱索置入不失为一种合适的选择。Objective: To evaluate 5 year efficacy of mitral valve replacement with artificial chordae tendineae. Methods: Patients who underwent mitral valve replacement surgery with preservation of posterior leaflet and subvalvular structures or artificial chordae tendineae implantation were divided into two groups with a follow-up of more than 5 years. Artificial chordae tendineae implantation was performed in Group 1 during mitral valve replacement, which contain 30 patients. Group 2 included 30 patients with mitral valve replacement while retaining all or part of the posterior valve. Ultrasound result were compared 5 years after surgery. Results: For mitral valve replacement, both the artificial tendinous cord implantation and the preservation of the subvalvular structure of patients had good postoperative improvement, intermediate result are equivalent. Conclusions: During mitral valve replacement, when with severe calcification of the subvalvular structure, severe adhesion of the chordae tendineae, papillary muscles and valve, and fusion leading to the failure of subvalvular structures retention, artificial chordae tendineae implantation may be an appropriate choice.

关 键 词：风湿性心脏病 二尖瓣置换 人工腱索 保留后瓣 左心室功能 

分 类 号：R54[医药卫生—心血管疾病]