Guedes Marco Antonio Vieira, Pomerantzeff Pablo Maria Alberto, Brandão Carlos Manuel de Almeida, Vieira Marcelo Luiz Campos, Leite Filho Osanam Amorim, Silva Marcos Floripes da, Spinola Pablo da Cunha, Stolf Noedir Antonio Groppo
Sociedade Brasileira de Cirurgia Cardiovascular, FMUSP, São Paulo, Brasil.
Rev Bras Cir Cardiovasc. 2010 Oct-Dec;25(4):534-42. doi: 10.1590/s0102-76382010000400018.
Mitral valve repair is the treatment of choice to correct mitral insufficiency. Although the literature related to left atrial and ventricular behavior after mitral repair without use of prosthetic rings is scarce.
To analyze cardiac morphology and function using real time tridimensional echocardiography in individuals submitted to mitral valve repair with Double Teflon technique.
Were included 14 patients with mixomatous mitral valve insufficiency that were submitted to mitral valve repair with the Double Teflon technique. Of them, 13 patients were in class III/IV. Patients were evaluated in preoperative period, immediate postoperative period, 6 months and 1 year after mitral repair. Statistic analysis was made by repeated measures ANOVA test and was considered statistically significant P <0.05.
The analysis of systolic volumes, atrial and ventricular, demonstrated a significant volumetric reduction between immediate postoperative period and 1 year (P = 0.028 and P = 0.020, respectively). Between preoperative period and 1 year, there was a mean reduction in atrial and ventricle volumes of 19.9% and 15.4%, respectively. Atrial and ventricle diastolic volumes presented a significant reduction in immediate postoperative period (P <0.001 and P = 0.024, respectively), remaining stable during the study. There was an increase in left atrial ejection fraction after 6 months (P <0.001), although there was no significant variation in left ventricle ejection fraction.
Patients submitted to mitral valve repair by the Double Teflon technique demonstrated a left atrial and ventricle reverse remodeling. These reductions were associated with an improvement in left atrial function during the study.
二尖瓣修复是纠正二尖瓣关闭不全的首选治疗方法。尽管关于不使用人工瓣环进行二尖瓣修复后左心房和心室行为的文献较少。
使用实时三维超声心动图分析采用双特氟龙技术进行二尖瓣修复的患者的心脏形态和功能。
纳入14例患有黏液样二尖瓣关闭不全并采用双特氟龙技术进行二尖瓣修复的患者。其中,13例患者心功能为III/IV级。在二尖瓣修复术前、术后即刻、术后6个月和1年对患者进行评估。采用重复测量方差分析进行统计学分析,P<0.05被认为具有统计学意义。
对心房和心室收缩容积的分析表明,术后即刻至1年期间容积显著减少(分别为P = 0.028和P = 0.020)。术前至1年期间,心房和心室容积平均分别减少19.9%和15.4%。心房和心室舒张容积在术后即刻显著减少(分别为P<0.001和P = 0.024),在研究期间保持稳定。6个月后左心房射血分数增加(P<0.001),尽管左心室射血分数无显著变化。
采用双特氟龙技术进行二尖瓣修复的患者表现出左心房和心室逆向重构。这些容积减少与研究期间左心房功能改善相关。