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人工腱索植入二尖瓣重建的临床经验

Clinical experience of mitral valve reconstruction with artificial chordae implantation.

作者信息

Kawazoe K, Eishi K, Sasako Y, Kosakai Y, Kitoh Y, Nakajima N, Kawashima Y

机构信息

Department of Cardiovascular Surgery, National Cardiovascular Center, Osaka, Japan.

出版信息

Eur J Cardiothorac Surg. 1992;6(6):297-301. doi: 10.1016/1010-7940(92)90145-n.

Abstract

To expand the application of mitral valve reconstruction for pure mitral regurgitation due to diffuse leaflet prolapse, we have employed artificial chordae implantation using GPEP strips in 9 patients and 4-0 PTFE sutures in 20 patients since November 1986. The total number of GPEP strips implanted was 20 with a range from 1 to 4 (average 2.2 per patient) and 45 pairs of PTFE sutures with a range from 1 to 6 (average 2.3 per patient). There was one hospital death (3.4%). All other patients survived operation without valve-related complications except 1 patient who required reoperation for failure of mitral valve reconstruction. In 27 survivors free from reoperation, the amount of mitral regurgitation assessed postoperatively was none or trivial in 19 patients, mild in 7 and moderate in 1. All 27 patients improved to NYHA functional class I or II. So far, our results were no less acceptable than those with conventional procedures for mitral valve prolapse.

摘要

为扩大二尖瓣重建术在因弥漫性瓣叶脱垂导致的单纯二尖瓣反流中的应用,自1986年11月以来,我们对9例患者采用了GPEP条带进行人工腱索植入,对20例患者采用了4-0 PTFE缝线。植入的GPEP条带总数为20条,范围为1至4条(平均每位患者2.2条),45对PTFE缝线,范围为1至6对(平均每位患者2.3对)。有1例医院死亡(3.4%)。除1例因二尖瓣重建失败需要再次手术的患者外,所有其他患者术后存活且无瓣膜相关并发症。在27例未再次手术的存活患者中,术后评估二尖瓣反流程度,19例患者无或微量反流,7例为轻度反流,1例为中度反流。所有27例患者的心功能均改善至纽约心脏协会(NYHA)功能I级或II级。到目前为止,我们的结果与二尖瓣脱垂的传统手术结果相比并不逊色。

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