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先天性二尖瓣畸形的外科修复

Surgical repair of congenital mitral valve malformations.

作者信息

Curi-Curi Pedro, Ramírez-Marroquín Samuél, Cervantes-Salazar Jorge, Soulé Mauricio, Erdmenger Julio, Calderón-Colmenero Juan

机构信息

Cirujano Cardiovascular Pediátrico.

出版信息

Arch Cardiol Mex. 2010 Apr-Jun;80(2):87-94.

Abstract

Surgical development of mitral valve repair techniques in pediatric patients has been slow because of the great variety in the presentation of congenital mitral valve malformations and the still unknown growing effect over the complex mitral valve apparatus. The aim of this study is to review our early an mid-term institutional outcomes in surgical repair of congenital mitral valve malformations. We studied retrospectively 14 patients with surgical repair of congenital mitral valve malformations in a 5 year period. Clinical and echocardiographic follow-up at a mean of 25 months was performed in all cases. Operative morbidity was 77% and operative mortality 7%. There were no late deaths. Clinical functional class stratification at the mid-term improved in 73% of survivors and did not change in the remaining 27%. Freedom from reoperation for mitral valve prosthetic replacement due to mitral valve repair failure was 84% at 30 days and 77% at 3.5 years. Surgical repair is probably the best technique option in the treatment of congenital malformations of the mitral valve, and transesophageal intraoperatory echocardiography must be highly recommended for evaluation of results.

摘要

由于先天性二尖瓣畸形的表现形式多种多样,且对复杂二尖瓣装置的生长影响尚不清楚,小儿患者二尖瓣修复技术的外科发展一直较为缓慢。本研究的目的是回顾我们在先天性二尖瓣畸形外科修复方面的早期和中期机构治疗结果。我们回顾性研究了5年内接受先天性二尖瓣畸形外科修复的14例患者。所有病例均进行了平均25个月的临床和超声心动图随访。手术并发症发生率为77%,手术死亡率为7%。无晚期死亡病例。中期时,73%的幸存者临床功能分级得到改善,其余27%未发生变化。因二尖瓣修复失败而行二尖瓣人工瓣膜置换再次手术的免再手术率在30天时为84%,在3.5年时为77%。外科修复可能是治疗先天性二尖瓣畸形的最佳技术选择,强烈推荐术中经食管超声心动图用于评估手术结果。

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