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先天性瓣上二尖瓣环切除术的中期结果

Mid-Term Results of Congenital Supravalvar Mitral Ring Resection.

作者信息

Yildirim Ozgur, Ozyuksel Arda, Avsar Mustafa, Yerebakan Can, Zeybek Cenap, Demiroluk Sener, Bilal Mehmet Salih

机构信息

Department of Cardiovascular Surgery, Medicana International Hospital, Istanbul, Turkey.

Department of Cardiovascular Surgery, Medipol University, Istanbul, Turkey.

出版信息

J Card Surg. 2015 Jul;30(7):591-4. doi: 10.1111/jocs.12554. Epub 2015 May 4.

Abstract

BACKGROUND

Supravalvar mitral ring is a rare congenital anomaly leading to left ventricle inflow obstruction. We present our surgical experience and mid-term results in patients operated for supravalvar mitral ring and associated congenital heart defects.

MATERIALS AND METHODS

A retrospective analysis was performed in order to evaluate the cases surgically treated with the diagnosis of supravalvar mitral ring between 2001 and 2014. Ten patients were identified, seven of whom had accompanying congenital heart defects. Median age at the operation was 4.5 years.

RESULTS

Ventricular septal defects were encountered in half of the cases. Two of the patients had mitral annular hypoplasia, another two had the components of Shone's complex. The mean preoperative gradient across the supravalvar mitral ring decreased from 14.1 ± 4.2 mmHg to 4.6 ± 2.2 mmHg. All patients are alive and remain in a good clinical condition after a mean follow-up of five years.

CONCLUSION

Supravalvar mitral ring is a surgically treatable cause of left ventricular inflow obstruction. Although residual gradients may be encountered in patients with mitral annular hypoplasia, surgical resection of the ring is encouraged.

摘要

背景

瓣上二尖瓣环是一种导致左心室流入道梗阻的罕见先天性异常。我们介绍了对因瓣上二尖瓣环及相关先天性心脏缺陷而接受手术治疗的患者的手术经验和中期结果。

材料与方法

进行了一项回顾性分析,以评估2001年至2014年间经手术治疗且诊断为瓣上二尖瓣环的病例。共确定了10例患者,其中7例伴有先天性心脏缺陷。手术时的中位年龄为4.5岁。

结果

半数病例存在室间隔缺损。2例患者有二尖瓣环发育不全,另外2例有绍内综合征的组成部分。瓣上二尖瓣环术前平均压差从14.1±4.2mmHg降至4.6±2.2mmHg。所有患者均存活,平均随访五年后临床状况良好。

结论

瓣上二尖瓣环是一种可通过手术治疗的左心室流入道梗阻病因。尽管二尖瓣环发育不全的患者可能会出现残余压差,但仍鼓励对瓣环进行手术切除。

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