Karamatov A Sh, Ivanov V A
Grudn Khir. 1989 Sep-Oct(5):5-8.
The authors report on 64 valve-preserving operations conducted under conditions of extracorporeal circulation in patients with a history of closed mitral commissurotomy (59 patients with restenosis of the mitral orifice and 5 patients with iatrogenic mitral insufficiency); hospital lethality was 14%. The peculiarities of the diagnosis and operative techniques of the second intervention in this pathological condition are discussed in detail. From study of the immediate postoperative results the authors conclude that during the second operation after closed mitral commissurotomy the patient's own valve can be preserved in 30-35% of cases. They claim that restenosis of the mitral orifice and iatrogenic mitral insufficiency are a complicated form of mitral valvular disease and should be corrected on an open heart with extracorporeal circulation.
作者报告了64例在体外循环条件下进行的保留瓣膜手术，这些患者有闭式二尖瓣交界切开术病史（59例二尖瓣口再狭窄患者和5例医源性二尖瓣关闭不全患者）；医院死亡率为14%。详细讨论了在这种病理状况下二次干预的诊断特点和手术技术。通过对术后即刻结果的研究，作者得出结论，在闭式二尖瓣交界切开术后的二次手术中，30% - 35%的病例可保留患者自身瓣膜。他们声称二尖瓣口再狭窄和医源性二尖瓣关闭不全是二尖瓣疾病的复杂形式，应在体外循环下进行心脏直视手术予以纠正。
