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使用半刚性瓣环成形带进行二尖瓣瓣环成形术治疗缺血性二尖瓣反流:早期结果

Mitral valve annuloplasty with a semirigid annuloplasty band in ischemic mitral regurgitation: early results.

作者信息

Formica Francesco, Corti Fabrizio, Sangalli Fabio, Greco Pierpaolo, Ferro Orazio, Colagrande Luisa, Paolini Giovanni

机构信息

Cardiac Surgery Clinic, Department of Surgical Science, University of Milan-Bicocca, San Gerardo Hospital, Monza (MI), Italy.

出版信息

J Cardiovasc Med (Hagerstown). 2007 Jul;8(7):499-503. doi: 10.2459/01.JCM.0000278443.58870.26.

Abstract

OBJECTIVE

A trigone-to-trigone semirigid annuloplasty band (C-G Future Band, Medtronic, Inc., Minneapolis, Minnesota, USA) was introduced in 2001 for mitral valve repair. We report our early clinical and echocardiographic results with this new device to correct ischemic mitral regurgitation.

METHODS

Between January 2002 and December 2004, among 216 patients operated on for mitral regurgitation, 107 patients had a C-G Future Band annuloplasty and 85 consecutive patients (72.6% male; mean age 66.9 +/- 8.6 years) received this annuloplasty band to correct ischemic mitral regurgitation. Mean follow-up was 14.3 +/- 9.8 months (range 0.2-37 months). Clinical and echocardiographic assessment was accomplished preoperatively, postoperatively, at 6 and 12 months, and at two years.

RESULTS

Perioperative mortality was 3.7% (three in-hospital deaths), whereas overall survival at two years was 88.7 +/- 4.2%. Immediately after repair, echocardiographic mitral regurgitation was dramatically reduced (2.5 +/- 0.6 vs. 0.9 +/- 0.6; P < 0.0001); ejection fraction increased from 43.8 +/- 11% preoperatively to 44.8 +/- 12% postoperatively (P = 0.007). At the time of follow-up, New York Heart Association (NYHA) functional class was significantly improved (mean preoperative NYHA class 2.04 +/- 0.9 vs. mean postoperative NYHA class 1.25 +/- 0.6; P < 0.0001). No patient experienced thromboembolic events and no late mitral valve reoperation occurred.

CONCLUSIONS

Early and mid-term mitral valve function is satisfactory with trigone-to-trigone semirigid band annuloplasty, with excellent repair durability immediately after the operation and at two years. Moreover, after annuloplasty repair, an improvement in clinical functional status is obtained. A wider use of this semirigid annuloplasty band can be recommended.

摘要

目的

一种从三角区到三角区的半刚性瓣环成形带(C-G Future Band,美敦力公司,明尼阿波利斯,明尼苏达州,美国)于2001年被引入用于二尖瓣修复。我们报告使用这种新装置纠正缺血性二尖瓣反流的早期临床和超声心动图结果。

方法

在2002年1月至2004年12月期间,在216例接受二尖瓣反流手术的患者中,107例患者进行了C-G Future Band瓣环成形术,85例连续患者(男性占72.6%;平均年龄66.9±8.6岁)接受了这种瓣环成形带以纠正缺血性二尖瓣反流。平均随访时间为14.3±9.8个月(范围0.2 - 37个月)。术前、术后、6个月、12个月和两年时进行临床和超声心动图评估。

结果

围手术期死亡率为3.7%(3例住院死亡),而两年时的总生存率为88.7±4.2%。修复后即刻,超声心动图显示二尖瓣反流显著减少(2.5±0.6对0.9±0.6;P<0.0001);射血分数从术前的43.8±11%增加到术后的44.8±12%(P = 0.007)。在随访时,纽约心脏协会(NYHA)心功能分级显著改善(术前平均NYHA分级2.04±0.9对术后平均NYHA分级1.25±0.6;P<0.0001)。没有患者发生血栓栓塞事件,也没有晚期二尖瓣再次手术发生。

结论

从三角区到三角区的半刚性带瓣环成形术的早期和中期二尖瓣功能令人满意,术后即刻和两年时修复耐久性良好。此外,瓣环成形修复后,临床功能状态得到改善。可以推荐更广泛地使用这种半刚性瓣环成形带。

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