Sakamoto Yoshimasa, Yoshitake Michio, Matsumura Hirotaka, Yamashiro Masahito, Yamamoto Yusuke, Hashimoto Kazuhiro
Department of Cardiac Surgery, Jikei University School of Medicine, Tokyo, Japan.
Kyobu Geka. 2012 Apr;65(4):280-6.
Leaflet resection for posterior leaflet prolapse has been a standard repair procedure with good longterm durability. The aim of this study was to review our experience of mitral valve repair, in which resection of the anterior and/or posterior leaflets was performed. Between October 1991 and December 2010, 172 patients with degenerative mitral valve regurgitation underwent mitral valve reconstruction,including 98 patients with the posterior leaflet prolapse, 47 patients with the anterior leaflet prolapse, 17 patients with both leaflets and 10 patients with the commissure prolapse. Most patients in this study were supposed to be caused by fibroelastic deficiency and we have not experienced systolic anterior motion after repair. The mean follow-up period was 8.7 ± 5.5 years. The freedom from reoperation rates at 15 years in 88.7 ± 5.3% of the anterior leaflet procedure, 96.6 ± 2.5% of the posterior leaflet, and 100% of both leaflets. The results of resection of a diseased prolapsed mitral leaflet have been promising so far. However, reoperation was required in 7 patients (4.1%) and reoperation rate was higher in patients with anterior prolapse and longer follow-up will evaluate precisely be benefit.
对于后叶脱垂行瓣叶切除术一直是一种标准的修复手术，长期效果良好。本研究的目的是回顾我们在二尖瓣修复方面的经验，其中进行了前叶和/或后叶的切除。在1991年10月至2010年12月期间，172例退行性二尖瓣反流患者接受了二尖瓣重建，包括98例后叶脱垂患者、47例前叶脱垂患者、17例双叶脱垂患者和10例瓣环脱垂患者。本研究中的大多数患者被认为是由纤维弹性缺乏引起的，我们在修复后未经历收缩期前向运动。平均随访期为8.7±5.5年。前叶手术15年时再次手术率为88.7±5.3%，后叶为96.6±2.5%，双叶为100%。到目前为止，切除病变的脱垂二尖瓣叶的结果很有前景。然而，7例患者（4.1%）需要再次手术，前叶脱垂患者的再次手术率更高，更长时间的随访将更准确地评估其益处。
