Gregori Júnior Francisco, Godoy Moacir Fernandes de, Cordeiro Celso Otaviano, Murakami Alexandre Noboru, Teruya Rogerio, Hayashi Sergio Shigueru, Aquino Wallace Kohata de, Gallina Luiz Eduardo
Surgical Clinics at Londrina State University (UEL), Hospital Evangélico de Londrina, Paraná, Brazil.
Rev Bras Cir Cardiovasc. 2013 Mar;28(1):36-46. doi: 10.5935/1678-9741.20130007.
To evaluate clinically and by Doppler Echocardiography 22 patients submitted to mitral valve repair after valvular regurgitation using standardized bovine pericardium chordae.
The patients had degenerative mitral regurgitation. Fourteen (63.6%) patients were male and the age ranged from 19 to 76 years (mean 56.8 ± 13.8 years). The strings of bovine pericardium treated with glutaraldehyde were reinforced in its transverse ends forming a trapezoid.
One patient (4.5%) died in the immediate postoperative period with in low cardiac output syndrome and three (13.6%) in the late postoperative period. One patient (4.5%) was reoperated. The actuarial curves for survival free of death from cardiovascular causes and free from reoperation for patients who left the hospital (21), showed rates of 82.0 ± 9.8% and 83.9 ± 10.4% at 70 months postoperatively, respectively. Seventeen patients (77.3%) are alive with native valves. Of the 17 patients alive with native valves 16 (94.1%) were in functional class I. The Doppler Echocardiography postoperatively (mean 41 months, 4-70 months), showed no mitral regurgitation in 11 (64.7%) patients and mild regurgitation in five (29.4%).
The technique of standard cords of bovine pericardium implantation to replace chordae tendineae of the mitral valve in patients with degenerative mitral regurgitation showed satisfactory results.
通过临床评估和多普勒超声心动图，对22例因瓣膜反流接受二尖瓣修复术并使用标准化牛心包腱索的患者进行评估。
患者患有退行性二尖瓣反流。14例（63.6%）为男性，年龄在19至76岁之间（平均56.8±13.8岁）。用戊二醛处理的牛心包弦线在其横向末端得到加强，形成梯形。
1例患者（4.5%）在术后即刻死于低心排血量综合征，3例（13.6%）在术后晚期死亡。1例患者（4.5%）再次手术。出院患者（21例）的无心血管原因死亡和无再次手术的生存精算曲线显示，术后70个月时的生存率分别为82.0±9.8%和83.9±10.4%。17例患者（77.3%）保留了自身瓣膜存活。在17例保留自身瓣膜存活的患者中，16例（94.1%）心功能为I级。术后多普勒超声心动图检查（平均41个月，4至70个月）显示，11例患者（64.7%）无二尖瓣反流，5例患者（29.4%）有轻度反流。
在退行性二尖瓣反流患者中，采用标准牛心包索植入技术替代二尖瓣腱索，结果令人满意。
