经皮二尖瓣钳夹术治疗重度功能性二尖瓣反流  

Percutaneous mitral valve repair with MitraClip for severe functional mitral regurgitation

作　　者：丁建东[1] 徐荣丰 张晓黎[1] 丁秀霞[1] 王臻[2] 陆启同[3] 章晓国[1] 陈立娟[1] 马根山[1] DING Jiandong;XU Rongfeng;ZHANG Xiaoli;DING Xiuxia;WANG Zhen;LU Qitong;ZHANG Xiaoguo;CHEN Lijun;MA Genshan(Department of Cardiology,Zhongda Hospital,Southeast University,Nanjing 210009,China;Department of Anesthesiology,Zhongda Hospital,Southeast University,Nanjing 210009,China;Cardio-Thoracic Surgery,Zhongda Hospital,Southeast University,Nanjing 210009,China)

机构地区：[1]东南大学附属中大医院心内科,江苏南京210009 [2]东南大学附属中大医院麻醉科,江苏南京210009 [3]东南大学附属中大医院心胸外科,江苏南京210009

出　　处：《东南大学学报（医学版）》2021年第5期569-572,共4页Journal of Southeast University(Medical Science Edition)

基　　金：江苏省重点研发课题(7790000104)。

摘　　要：经皮二尖瓣钳夹术(MitraClip)已成为治疗二尖瓣反流(MR)的重要选择。对于有症状的严重MR的高手术风险患者,由于合并疾病的严重程度和相关的高死亡风险,MitraClip是一种替代治疗方法。该手术由三维经食管超声心动图(TEE)和X线引导,在二尖瓣前叶和后叶之间放置一个夹子,以减少二尖瓣反流。其优点是避免胸骨切开和体外循环,心脏不停跳下修复二尖瓣,并减少术后机械通气时间,无须转重症监护病房,并不需要输血。在江苏省内本文作者首次对1例56岁反复出现充血性心力衰竭症状患者应用MitraClip治疗因缺血性心肌病导致的重度功能性MR。The percutaneous MitraClip system is a transcatheter mitral valve repair system that has become an important option for treating mitral regurgitation(MR).MitraClip deployment is an alternative procedure in patients at high surgical risk with severe symptomatic MR who are not candidates for mitral valve(MV)repair/replacement due to their degree of co-morbidity and associated high mortality risk.The procedure is guided by 3-dimensional(3D)transesophageal echocardiography(TEE)and fluoroscopy.A clip is positioned between the anterior and posterior leaflet to reduce valve regurgitation.The advantages of the management are avoidance of sternotomy and cardiopulmonary bypass,beating-heart repair of the MV and reduction in post-operative duration of mechanical ventilation,intensive care unit stay and need for blood transfusion.We present the first case of a MitraClip deployment in an 56-year-old patient who suffered from recurrent symptoms of congestive heart failure due to ischemic cardiomyopathy and concomitant severe FMR in Jiangsu Province.

关 键 词：二尖瓣钳夹术 重度二尖瓣反流 江苏 

分 类 号：R542.51[医药卫生—心血管疾病]