Dion Robert A, Gutermann Herbert, Van Kerrebroeck Christiaan, Verhaert David
Department of Cardiac Surgery, Ziekenhuis Oost-Limburg, Genk, Belgium.
Multimed Man Cardiothorac Surg. 2012 Jan 1;2012:mms015. doi: 10.1093/mmcts/mms015.
The augmentation of mitral valve leaflets is mostly needed in rheumatic valve disease patients. The technical aspects of augmentation of the posterior leaflet by means of an autologous pericardial patch are described: the thickened and semi-rigid posterior leaflet is detached from the posterior annulus from commissure to commissure and augmented by an onlay patch of autologous pericardium which is incorporated using a continuous stitch-locked at each step-of Prolene or Pronova 5/0. The pitfall 'aortic cusp effect in diastole' is described as well as tips to prevent it.
二尖瓣瓣叶扩大术主要适用于风湿性瓣膜病患者。本文描述了使用自体心包补片扩大后叶的技术要点：增厚且半僵硬的后叶从瓣环后叶的瓣交界至瓣交界分离，并用自体心包补片覆盖扩大，补片采用连续缝合固定，使用普理灵或普诺凡5/0缝线，每一步都锁边。文中还描述了“舒张期主动脉瓣叶效应”这一陷阱以及预防方法。
