Jiang Zhaolei, Mei Ju, Ding Fangbao, Bao Chunrong, Zhu Jiaquan, Tang Min, Ma Nan, Huang Jianbing, Shen Saie
Department of Cardiothoracic Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, 1665 Kongjiang Road, Shanghai, 200092, China.
Surg Today. 2014 Nov;44(11):2086-91. doi: 10.1007/s00595-013-0816-x. Epub 2013 Dec 22.
To review the surgical techniques and mid-term results of mitral valve repair in children with moderate or severe mitral regurgitation (MR).
One hundred and seven children with moderate or severe MR, aged 19.6 ± 8.5 months, were enrolled in this study. The surgical techniques used for mitral valve repair varied according to the mitral valve morphology, and included annuloplasty, annuloplasty ring, cleft closure, reconstruction of the posterior leaflet, etc. The concomitant cardiac anomalies were treated simultaneously. The results of repair were evaluated by transesophageal echocardiography performed during the operation and by serial transthoracic echocardiography performed during the follow-up.
One hundred and six cases had no more than mild regurgitation intraoperatively, whereas only one case had moderate regurgitation. This patient underwent redo repair immediately, and the subsequent regurgitation was trivial. The in-hospital mortality rate was 0.9 % (1/107). The average follow-up was 46.5 ± 8.2 months. One patient died of heart failure 10 months postoperatively. The freedom from moderate or severe regurgitation after mitral valve repair was 92.3 ± 3.3 %.
Pediatric patients with moderate or severe MR require early surgical treatment. The early and mid-term results of mitral valve repair in pediatric patients were satisfactory.
回顾中重度二尖瓣反流(MR)患儿二尖瓣修复的手术技术及中期结果。
107例中重度MR患儿纳入本研究,年龄19.6±8.5个月。二尖瓣修复所采用的手术技术根据二尖瓣形态而异,包括瓣环成形术、瓣环成形环、裂隙闭合、后叶重建等。同时处理合并的心脏畸形。术中经食管超声心动图及随访期间系列经胸超声心动图评估修复结果。
106例术中反流不超过轻度,仅1例为中度反流。该患者立即接受再次修复,随后反流轻微。住院死亡率为0.9%(1/107)。平均随访46.5±8.2个月。1例患者术后10个月死于心力衰竭。二尖瓣修复后无中度或重度反流的比例为92.3±3.3%。
中重度MR的儿科患者需要早期手术治疗。儿科患者二尖瓣修复的早期和中期结果令人满意。