保留瓣下结构的二尖瓣替换术67例报告  

Mitral Valve Replacement With Preservation of Subvalvular Apparatus

作　　者：郭德和[1] 韩育宁[1] 李晋南[1] 

机构地区：[1]宁夏医学院附属医院胸心外科,银川750004

出　　处：《宁夏医学院学报》2003年第2期93-94,共2页Journal of Ningxia Medical College

摘　　要：目的 :评价保留瓣下结构的二尖瓣替换术的临床效果。方法 :回顾分析自 1991年 3月至 2 0 0 2年 6月应用此法的 6 7例手术病人。全组男 30例 ,女 37例。年龄 39 4 8± 11 95岁 (16～ 6 4岁 )。二尖瓣病变为 :二尖瓣关闭不全 (MI) 16例 ,二尖瓣狭窄 (MS) 15例及MI +S 35例。手术全部在低温体外循环下进行。保留全瓣膜和瓣下结构 4例 ,保留部分瓣膜和瓣下结构 6 3例。结果 :全组无手术死亡。并发症 :低心排 3例 ,心律紊乱 6例 ,肾功能衰竭 1例 ,2次止血 1例。随访 3个月至 3年。 1例术后 3年死于感染性心内膜炎。结论 :保留瓣下结构的二尖瓣替换手术对心功能的恢复是安全有效的。Objective: To value the virtues of mitral valve replacement with preservation of subvalvular apparatus. Methods: From Mar. 1991 to June 2002, 67 patient (30 males and 37 females, aged 16～64 years (with mean of 39～48±11.95) underwent mitral valve replacement (MVR) with preservation of subvalvular apparatus. The mitral valve diseases were: mitral valve insufficiency (MI) 16 cases, mitral valve stenosis (MS) 15 cases, and MI+MS 35 cases. All cases were operated on under hypothermia and cardiopulmonary bypass. MVR with preservation of total subvalvular apparatus was performed in 4 cases, partially in 63 cases. Results: There was no immediate death after operation. The complications were low cardiac output syndrome in 3 cases, arrhythmias 4 cases, renal insufficiency 1 cases and hemorrhage 1 cases. All the patients were followed for 2 months to 3 years. One case died 3 years after operation due to infective endocarditis. Conclusion: In severe cases of mitral incompetence and mitral stenosis, the affected valve should be replaced with an artificial one. Mitral valve replacement with preservation of subvalvular apparatus is a safe and effective method beneficial to functional recovery.

关 键 词：保留瓣下结构 二尖瓣替换术 临床效果 二尖瓣关闭不全 二尖瓣狭窄 

分 类 号：R654.2[医药卫生—外科学]