Yamauchi Takashi, Taniguchi Kazuhiro, Kuki Satoru, Masai Takafumi, Noro Masaki, Nishino Masami, Fujita Shinichi
Department of Cardiovascular Surgery, Labour Welfare Corporation Osaka Rosai Hospital, Nagasone-cho, Sakai Osaka, Japan.
J Card Surg. 2005 Sep-Oct;20(5):432-5. doi: 10.1111/j.1540-8191.2005.200329.x.
In clinical settings, information on morphology of mitral valve leaflet after mitral valve reconstruction is limited.
Between January 1996 and June 2000, 36 patients underwent mitral valve repair for mitral regurgitation (MR). The etiology of mitral insufficiency was prolapse, dilated annulus, and ischemia. Ring annuloplasty was performed in all cases. Mitral valve short-axis dimension (MVd), vertical distance between annular line and closing point (Vd), coaptation length (CL), and coaptation length index (CLI) were measured by two-dimensional transesophageal echocardiography for the present 11 cases.
In 11 cases, residual MR, using a scale from 0 to 4, was 0 in 5 patients, 1 in 4 patients, 2 in 2 patients whose etiology of regurgitation was cardiomyopathy. MVd and Vd decreased significantly (38.7+/- 6.2 to 27.0 +/- 5.6 mm, 10.1 +/- 7.7 to 6.5 +/- 4.6 mm, respectively). CL and CLI increased significantly (6.4 +/- 2.4 to 11.6 +/- 4.6 mm, 0.16 +/- 0.06 to 0.44 +/- 0.21, respectively). Among those indices, only CLI has a statistically significant negative correlation with the degree of residual MR.
Mitral valve ring annuloplasty produces the morphologic change of the mitral apparatus, especially increase of CLI, which may be one of the main factors in regulation of regurgitation.
在临床环境中，二尖瓣重建术后二尖瓣叶形态学的相关信息有限。
1996年1月至2000年6月期间，36例患者因二尖瓣反流（MR）接受二尖瓣修复术。二尖瓣关闭不全的病因包括脱垂、瓣环扩张和缺血。所有病例均进行了瓣环成形术。对目前的11例患者采用二维经食管超声心动图测量二尖瓣短轴径（MVd）、瓣环线与闭合点之间的垂直距离（Vd）、瓣叶对合长度（CL）和瓣叶对合长度指数（CLI）。
在11例患者中，采用0至4级评分，5例患者残余MR为0级，4例患者为1级，2例反流病因是心肌病的患者为2级。MVd和Vd显著降低（分别从38.7±6.2mm降至27.0±5.6mm，从10.1±7.7mm降至6.5±4.6mm）。CL和CLI显著增加（分别从6.4±2.4mm增至11.6±4.6mm，从0.16±0.06增至0.44±0.21）。在这些指标中，只有CLI与残余MR程度存在统计学显著负相关。
二尖瓣瓣环成形术会引起二尖瓣装置的形态学改变，尤其是CLI增加，这可能是调节反流的主要因素之一。
