Cheng L C, Chiu C S, Lee J W
Department of Surgery, University of Hong Kong, Hong Kong.
J Cardiovasc Surg (Torino). 1999 Jun;40(3):339-42.
What are the immediate and long term outcomes of patients who had rupture of the left ventricle after mitral valve replacement?
A retrospective study with a 20-year follow-up.
Experience in a single tertiary referral cardiothoracic surgery hospital.
20 out of 3105 patients that received mitral valve replacement.
All these 20 patients received re-exploration for a trial of repair of left ventricular rupture either by an internal or an external or a combined repair.
Operative mortality and long term outcome of the survivals.
Most patients (16.80%) were female and had rheumatic mitral valve disease. The mean age of the patients was 58.1 years. All patients underwent attempted repair, usually by removal of the prosthesis and reconstitution of the ventricle from within the left atrium (75%). Thirteen (65%) patients died. Two late deaths were of unrelated cause. One surviving patient developed a late ventricular false aneurysm but did not undergo repeat surgery. One patient developed severe mitral regurgitation due to tissue failure of the bioprosthesis 12 years after surgery and she underwent a successful reoperation.
We believe that all patients should be placed back on cardiopulmonary bypass for an internal repair. The long term outcome of the survivals is satisfactory.
二尖瓣置换术后左心室破裂患者的近期和远期预后如何？
一项为期20年随访的回顾性研究。
一家三级转诊心胸外科医院的经验。
3105例接受二尖瓣置换术的患者中的20例。
这20例患者均接受再次开胸手术，尝试通过心内、心外或联合修复方法修复左心室破裂。
手术死亡率及存活者的远期预后。
大多数患者（16.80%）为女性，患有风湿性二尖瓣疾病。患者的平均年龄为58.1岁。所有患者均尝试进行修复，通常是通过移除人工瓣膜并从左心房内部重建心室（75%）。13例（65%）患者死亡。2例晚期死亡与本病无关。1例存活患者出现晚期心室假性动脉瘤，但未接受再次手术。1例患者术后12年因生物瓣膜组织衰竭出现严重二尖瓣反流，随后成功接受再次手术。
我们认为所有患者均应进行体外循环下心内修复。存活者的远期预后令人满意。
