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新型半刚性二尖瓣成形环(索林Memo 3D)的早期临床经验及超声心动图结果

Early clinical experience and echocardiographic results with a new semirigid mitral annuloplasty ring: the Sorin Memo 3D.

作者信息

Bruno Pier Giorgio, Leva Cristian, Santambrogio Luisa, Lazzarini Ilaria, Musazzi Giorgio, Del Rosso Gianfranco, Di Credico Germano

机构信息

Department of Cardiac Surgery, Echocardiography Unit, Ospedale Civile di Legnano, Milan, Italy.

出版信息

Ann Thorac Surg. 2009 Nov;88(5):1492-8. doi: 10.1016/j.athoracsur.2009.07.017.

Abstract

BACKGROUND

The Sorin Memo 3D (Sorin Biomedica Cardio S.r.L., Saluggia, Italy) is a new, complete semirigid annuloplasty ring. Clinical use, outcomes, and echocardiographic results are reported as an evaluation of its safety and efficacy in the treatment of mitral valve regurgitation (MVR).

METHODS

This device was assessed in 63 patients (63.5% men; mean age, 70.2 +/- 10.3 years) who underwent MVR operations between January 2007 and June 2008. Functional classification was normal leaflet motion (type I; 1.6%), leaflet prolapse (type II; 66.7%), and restricted leaflet motion (type III; 31.7%). Valve disease was degenerative (68.25%), ischemic (25.4%), and nonischemic dilated cardiomyopathy (6.35%).

RESULTS

Early mortality (< or = 30 days) was 3.3% (2 patients). Late mortality (11.2 +/- 5.1 months) was 4.9% (3 patients). No deaths were device-related. Thromboembolic stroke occurred in 3.3% and endocarditis in 1.6%. Freedom from reoperation was 98.4%. At 6 months, MVR was grade 0/1 in 93.7% and grade 2+ in 6.4%. Left end-diastolic ventricular diameters decreased significantly from 59.3 +/- 6.9 mm preoperatively to 50.6 +/- 12.2 mm at 6 months, pulmonary arterial pressure decreased from 44.8 +/- 7.1 mm Hg to 38.4 +/- 5.5 mm Hg, and left ventricular ejection fraction increased significantly from 0.469 +/- 0.129 to 0.582 +/- 0.106. New York Heart Association functional class was I in 81% and II in 13.8%.

CONCLUSIONS

Early results indicate the Sorin Memo 3D ring safely and effectively minimizes secondary MVR resulting from all causes and preserves mitral annular flexibility and function at follow-up.

摘要

背景

索林Memo 3D(索林生物医学心脏有限公司,意大利萨卢贾)是一种新型的、完整的半刚性瓣环成形环。本文报告了其临床应用、结果及超声心动图结果,以评估其在治疗二尖瓣反流(MVR)中的安全性和有效性。

方法

对2007年1月至2008年6月期间接受MVR手术的63例患者(男性占63.5%;平均年龄70.2±10.3岁)使用该装置进行评估。功能分类为瓣叶运动正常(I型;1.6%)、瓣叶脱垂(II型;66.7%)和瓣叶运动受限(III型;31.7%)。瓣膜疾病为退行性(68.25%)、缺血性(25.4%)和非缺血性扩张型心肌病(6.35%)。

结果

早期死亡率(≤30天)为3.3%(2例患者)。晚期死亡率(11.2±5.1个月)为4.9%(3例患者)。无死亡与装置相关。血栓栓塞性卒中发生率为3.3%,心内膜炎发生率为1.6%。再次手术率为98.4%。6个月时,93.7%的患者MVR为0/1级,6.4%的患者为2+级。左心室舒张末期直径从术前的59.3±6.9mm显著降至6个月时的50.6±12.2mm,肺动脉压从44.8±7.1mmHg降至38.4± 5.5mmHg,左心室射血分数从0.469±0.129显著增至0.582±0.106。纽约心脏协会功能分级I级占81%,II级占13.8%。

结论

早期结果表明,索林Memo 3D环可安全有效地将各种原因导致的继发性MVR降至最低,并在随访中保留二尖瓣环的柔韧性和功能。

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