Attman W G, El Tahan S
Department of Cardiac Surgery, Faculty of Medicine, Alexandria University, Egypt.
Tex Heart Inst J. 1999;26(4):269-74.
Today, technical advances have decreased the risk of cardiopulmonary bypass to the point that closed mitral commissurotomy is performed infrequently in most cardiac centers and is considered hazardous. We describe a modified technique for closed mitral commissurotomy, improved in terms of safety and efficacy, and adapted for situations in which resources are limited. This operation was performed in 12 symptomatic patients with severe mitral stenosis whose valves were judged suitable for closed mitral commissurotomy or balloon valvuloplasty. After modified closed commissurotomy, the mitral valve areas of these patients were increased substantially, from 1.8 to 3.1 cm2. There was no new incidence of mitral regurgitation. We conclude that closed mitral commissurotomy is a safe alternative to open mitral commissurotomy, provided that patient selection criteria are strictly followed.
如今，技术进步已降低了体外循环的风险，以至于在大多数心脏中心，闭式二尖瓣交界切开术很少进行，且被认为具有危险性。我们描述了一种改良的闭式二尖瓣交界切开术技术，在安全性和有效性方面有所改进，并适用于资源有限的情况。该手术应用于12例有症状的重度二尖瓣狭窄患者，这些患者的瓣膜被判定适合进行闭式二尖瓣交界切开术或球囊瓣膜成形术。改良闭式交界切开术后，这些患者的二尖瓣瓣口面积从1.8平方厘米大幅增加至3.1平方厘米。没有新的二尖瓣反流发生。我们得出结论，只要严格遵循患者选择标准，闭式二尖瓣交界切开术是开胸二尖瓣交界切开术的一种安全替代方法。
