Kshettry Vibhu R, Aranki Sary F
Minneapolis Heart Institute, Cardiac, Thoracic and Transplant Surgery, 920 East 28th Street, Suite 610, Minneapolis, MN 55407, USA.
J Heart Valve Dis. 2012 Nov;21(6):690-5.
The current trends in the surgical technique of mitral valve repair (MVR) among North American medical centers participating in the Sorin Valve Repair Registry are described.
A total of 2,314 MVR procedures was performed and documented between 2003 and 2009 at 89 North American medical centers. Surgical procedure characteristics on all mitral valve annuloplasty and valve reconstructions were collected by participating surgeons, and documented in the registry.
Early in the reporting period (between 2003 and 2007), posterior leaflet resection comprised 60% of all MVR procedures, but the percentage declined systematically through the years 2008 (56.1%) and 2009 (50.4%). A decrease over time was also observed in the frequency of sliding valvuloplasty procedures (from -30% in 2003 to 4.0% in 2009). Proportions of chordal repair techniques tended to increase towards the end of the reporting period, from a low of 15% in 2003 to a peak of 32% in 2008.
This report documents important trends in current MVR techniques among a representative cohort of surgical centers across North America. The data obtained were consistent with a practical shift from the conventional surgical MVR techniques to methods that allow a greater leaflet preservation--and thus less resection--over the latter half of the reporting period.
描述了参与索林瓣膜修复注册研究的北美医疗中心二尖瓣修复（MVR）手术技术的当前趋势。
2003年至2009年期间，北美89家医疗中心共进行并记录了2314例MVR手术。参与手术的外科医生收集了所有二尖瓣环成形术和瓣膜重建的手术过程特征，并记录在注册研究中。
在报告期早期（2003年至2007年），后叶切除术占所有MVR手术的60%，但该比例在2008年（56.1%）和2009年（50.4%）逐年系统性下降。滑动瓣膜成形术的频率也随时间下降（从2003年的30%降至2009年的4.0%）。在报告期接近尾声时，腱索修复技术的比例趋于增加，从2003年的15%的低点升至2008年的32%的峰值。
本报告记录了北美代表性外科中心队列中当前MVR技术的重要趋势。所获得的数据与在报告期后半段从传统外科MVR技术向允许更多保留瓣叶——从而减少切除——的方法的实际转变相一致。
