二尖瓣后叶折叠修复技术10年临床效果总结  

Ten years outcome of folding valvuloplasty in mitral regurgitation with posterior leaflet prolapse

作　　者：田白羽 王坚刚[1] 贡鸣[1] 张海波[1] 孟斐[1] 罗天戈[1] 焦玉清[1] 刘克敏 孟旭[1] 韩杰[1] TIAN Bai-yu;WANG Jian-gang;GONG Ming;ZHANG Hai-bo;MENG Fei;LUO Tian-ge;JIAO Yu-qing;LIU Ke min;MENG Xu;HAN Jie(Department of Cardiac Surgery,Beijing Anzhen Hospital,Capital Medical University,Beijing 100029,China)

机构地区：[1]首都医科大学附属北京安贞医院瓣膜外科中心,北京市100029

出　　处：《中国心血管病研究》2024年第4期331-335,共5页Chinese Journal of Cardiovascular Research

摘　　要：目的评价二尖瓣后叶折叠修复技术在治疗退行性二尖瓣关不全时的远期效果。方法回顾2010年1月至2019年12月于我中心由单一术者进行退行性二尖瓣修复的患者共1537例。经纳排标准筛选终入组207例。回顾患者术前超声资料,术中二尖瓣修复技术随访观察患者远期治疗效果。终点事件包括患者死亡情况,二尖瓣反流复查中度以上和再手术情况。结果207例患者均修复成功。出院时超声心动提示二尖瓣反流202例为轻度以下,5例为轻度。住院期间1例患者因原发性脑梗塞伴脑出血死亡。平均随访5.3年,随访过程中5例(2.43%)患者死亡,心脏相关死亡3例。12例中度以上反流,其中8例中度,4例重度,再手术患者3例。10年累计免于终点事件发生率为(84.99±3.83)%;10年生存率为(94.33±2.73)%;10年免于中度以上反流复发及再手术率为(90.4±2.9)%。结论二尖瓣后叶折叠是一种简单、可反复操作且治疗有效的修复技术,能够提供良好的远期效果。Objective To evaluate the long-term effect of posterior mitral leaflet folding repair technique in the treatment of degenerative mitral regurgitation.Methods A total of 1537 patients with degenerative mitral valve repair performed by a single surgeon in our center from January 2010 to December 2019 were reviewed.A total of 207 patients were enrolled.The preoperative echocardiography of the patients were reviewed and the patients were followed up to observe the long-term results.Results The 207 patients were successfully repaired.At discharge,the echocardiography examination indicated that mitral regurgitation was less than mild in 202 cases and mild in 5 cases.During hospitalization,1 patient died of cerebral hemorrhage due to primary cerebral infarction.During follow-up,5 patients(2.43%)died,of which 3 patients died of heart-related causes.Of the 12 patients with moderate or higher regurgitation,8 were moderate,4 were severe,and 3 were reoperated.The cumulative incidence of free end-point events in 10 years was(84.99±3.83)%.The 10-year survival rate was(94.33±2.73)%.The 10-year free rate of moderate or higher reflux recurrence and reoperation was(90.4±2.94)%.Conclusion Posterior mitral valve folding is a simple,repeatable and effective repair technique,which can provide good long-term results.

关 键 词：退行性二尖瓣关闭不全 二尖瓣修复术 二尖瓣后叶折叠 

分 类 号：R542.5[医药卫生—心血管疾病]