采用“双特氟龙”技术进行二尖瓣修复：10年随访结果

Mitral valve repair with "Double Teflon" technique: 10-year results.

作者信息

Brandão Carlos Manuel de Almeida, Guedes Marco Antonio Vieira, Silva Marcos Floripes da, Vieira Marcelo Luiz, Pomerantzeff Pablo Maria Alberto, Stolf Noedir Antonio Groppo

机构信息

Heart Institute (InCor) of University of São Paulo Faculty of Medicine Clinics Hospital, São Paulo, SP, Brazil.

出版信息

Rev Bras Cir Cardiovasc. 2007 Oct-Dec;22(4):448-53. doi: 10.1590/s0102-76382007000400011.

DOI:10.1590/s0102-76382007000400011

PMID:18488112

Abstract

OBJECTIVE

The purpose of this paper is to present the late clinical results of mitral valve repair with the "Double Teflon" technique.

METHODS

"Double Teflon" technique consists of a quadrangular resection of the posterior leaflet, annulus plication with "pledgetted" stitches over a Teflon patch, and leaflet suture. Between 1994 and 2003, 133 patients with degenerative mitral insufficiency due to ruptured or elongated chordae in the posterior leaflet underwent repair with this technique. The mean patient age was 60.4 years and 60.9% patients were male. According to clinical evaluation, 29.3% of the patients were in New York Heart Association functional class IV, 55.7% in class III and 15.0% in class II. Associated techniques of mitral valve repair were used in 15.2% of the patients; the most common was chordal shortening. Twenty six (19.5%) patients had associated procedures.

RESULTS

There was one (0.75%) operative death. In the late postoperative period, 95.5% of the surviving patients were in New York Heart Association functional class I. Linearized rates of thromboembolism, reoperation and death were 0.9%, 0.3% and 0.6% patient/year, respectively. The actuarial survival at 10 years was 94.7% +/- 3.6%. Actuarial freedom from thromboembolism and reoperation were 97.3 +/- 1.5% and 99.2 +/-0.8%, respectively. There were no episodes of hemolysis or endocarditis.

CONCLUSION

Mitral valve repair with "Double Teflon" technique presents low morbimorbidity and good clinical late evolution.

摘要

目的

本文旨在展示采用“双特氟龙”技术进行二尖瓣修复的晚期临床结果。

方法

“双特氟龙”技术包括对后叶进行四边形切除、在特氟龙补片上用带垫片缝线进行瓣环折叠以及瓣叶缝合。1994年至2003年间，133例因后叶腱索断裂或延长导致退行性二尖瓣反流的患者采用该技术进行修复。患者平均年龄为60.4岁，男性占60.9%。根据临床评估，29.3%的患者处于纽约心脏协会心功能IV级，55.7%处于III级，15.0%处于II级。15.2%的患者使用了二尖瓣修复的相关技术；最常见的是腱索缩短。26例（19.5%）患者进行了相关手术。

结果

有1例（0.75%）手术死亡。在术后晚期，95.5%的存活患者处于纽约心脏协会心功能I级。血栓栓塞、再次手术和死亡的线性化发生率分别为0.9%、0.3%和0.6%患者/年。10年的精算生存率为94.7%±3.6%。无血栓栓塞和再次手术的精算自由度分别为97.3±1.5%和99.2±0.8%。未发生溶血或心内膜炎事件。