用于功能性缺血性二尖瓣反流的乳头肌靠拢术。

Papillary muscle approximation for functional ischemic mitral regurgitation.

作者信息

Rama Akhtar, Praschker Levy, Barreda Eleodoro, Gandjbakhch Iradj

机构信息

Department of Thoracic and Cardiovascular Surgery, University of Paris VI Pierre et Marie, Groupe Hospitalier Pitie-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Paris, France.

出版信息

Ann Thorac Surg. 2007 Dec;84(6):2130-1. doi: 10.1016/j.athoracsur.2007.04.056.

DOI:10.1016/j.athoracsur.2007.04.056

PMID:18036963

Abstract

In patients with ischemic left ventricular dysfunction and functional mitral regurgitation, surgical treatment of mitral insufficiency remains a challenging issue. Several procedures have been described to restore a near to natural alignment between the mitral annulus and the laterally displaced papillary muscles. We report a new approach to relocate the displaced papillary muscles toward the mitral annulus and to reduce tethering in 8 patients, providing satisfactory initial results. Echocardiography showed mild or no mitral regurgitation at the follow-up (mean, 11.4 +/- 3.6 months; range = 7 to 14 months). This procedure is believed to be technically easy and beneficial in terms of mitral repair.

摘要

对于存在缺血性左心室功能障碍和功能性二尖瓣反流的患者，二尖瓣关闭不全的外科治疗仍然是一个具有挑战性的问题。已经描述了几种手术方法来恢复二尖瓣环与侧向移位的乳头肌之间接近自然的对齐。我们报告了一种将移位的乳头肌重新定位至二尖瓣环并减少瓣叶牵张的新方法，应用于8例患者，初步结果令人满意。超声心动图显示随访时（平均11.4±3.6个月；范围7至14个月）二尖瓣反流为轻度或无反流。该手术在技术上被认为是简单的，并且在二尖瓣修复方面是有益的。