Département de Chirurgie cardio-vasculaire, Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Paris, France.
J Thorac Cardiovasc Surg. 2012 Apr;143(4 Suppl):S17-20. doi: 10.1016/j.jtcvs.2011.11.016. Epub 2011 Dec 10.
Owing to the complexity of the underlying lesions, Barlow disease remains a challenge for surgeons performing mitral valve repair. We aimed to assess whether our most recent results involving several surgeons were comparable with those of a previous experience in which mitral valve repair was performed by a more limited group of surgeons.
From September 2000 to January 2007, 200 patients with Barlow disease (135 men and 65 women; mean age, 56 ± 13 years) were referred to our institution for surgical treatment of their mitral regurgitation. We retrospectively analysed the mitral lesions characteristics, the surgical techniques used, and clinical outcomes. Follow-up echocardiograms were biannually reviewed.
Lesions comprised annular dilatation, excess tissue, and leaflet prolapse in all cases. The most frequent prolapsed segments were P2 (88.5%; n = 177) and A2 (55.5%; n = 111). Annular calcifications and restrictive valvular motion were associated in 20% (n = 40). Repair was feasible in 94.7% (n = 179/189) of non-redo interventions. Immediate postoperative echocardiography showed residual mitral regurgitation greater than 1+ in 6 cases; these patients were all reoperated on within the next months. Operative mortality was 1.5% (n = 3). Mean follow-up was 77.5 ± 25.6 months. At 8 years postoperatively, overall survival was 88.6% ± 3.1%, freedom from reintervention was 95.3% ± 1.7%, and freedom from late recurrent moderate mitral regurgitation (>2+) was 90.2% ± 3.1%
Provided that the fundamental principles of mitral valve reconstruction are respected, the surgical techniques are highly reproducible with good long-term results, similar to those published during the pioneering phase of this surgery.
由于病变的复杂性，巴洛病仍然是进行二尖瓣修复手术的外科医生面临的挑战。我们旨在评估我们最近的结果是否与以前的经验相当，以前的经验是由一组数量有限的外科医生进行二尖瓣修复。
从 2000 年 9 月至 2007 年 1 月，200 例巴洛病患者（男性 135 例，女性 65 例；平均年龄 56±13 岁）因二尖瓣反流被转诊至我院接受手术治疗。我们回顾性分析了二尖瓣病变特征、手术技术和临床结果。每两年进行一次随访超声心动图检查。
所有病例均存在瓣环扩张、组织过多和瓣叶脱垂。最常见的脱垂节段为 P2（88.5%；n=177）和 A2（55.5%；n=111）。瓣环钙化和限制性瓣膜运动在 20%（n=40）的病例中并存。在非再次手术干预的 94.7%（n=179/189）病例中，修复是可行的。术后即刻超声心动图显示 6 例存在大于 1+的残余二尖瓣反流；这些患者均在接下来的几个月内再次手术。手术死亡率为 1.5%（n=3）。平均随访时间为 77.5±25.6 个月。术后 8 年，总生存率为 88.6%±3.1%，无再次干预的生存率为 95.3%±1.7%，无晚期复发性中度二尖瓣反流（>2+）的生存率为 90.2%±3.1%。
只要遵守二尖瓣重建的基本原则，手术技术具有高度可重复性，且长期效果良好，与该手术的开创性阶段发表的结果相似。
