Revuelta J M, Bernal J M, Gaite L, Alonso C, Vega J L, Durán C M
Rev Esp Cardiol. 1989 Aug-Sep;42(7):465-70.
Reconstructive surgery of the mitral valve is nowadays generally accepted to be a valid alternative to replacement. There is however little information on the long term stability of these techniques and specially the incidence of reoperation. In order to study this question all patients who had a Durán flexible ring annuloplasty performed between january 1975 and december 1976 were reviewed up to december 1987. Eighty seven flexible rings were placed in 85 patients. Aortic and/or tricuspid surgery was simultaneously performed in 44.8% of the patients. There were 2 hospital deaths (2.3% ) and 3 late deaths (3.5%). Ten patients were lost to follow up, all within 2 years after surgery. There were 18 thromboembolic events (11 central and seven peripheral) with one death. Thirteen patients required reoperation (17.8%) In 11 the valve was replaced and a new flexible ring annuloplasty was done in two, without mortality. The causes for reoperation were regurgitation in eight (10.9%) and stenosis in five (5.8%). When the lesion was regurgitant the average interval between operations was 20.6 months, and when stenotic of 87.8 months. It can be concluded that reconstructive surgery of the mitral valve, in this predominantly rheumatic group of patients, has an incidence or reoperation close to 18% at 12-13 years follow up.
如今，二尖瓣重建手术已被普遍认为是瓣膜置换术的一种有效替代方案。然而，关于这些技术的长期稳定性，特别是再次手术的发生率，目前所知甚少。为了研究这个问题，我们对1975年1月至1976年12月期间接受杜兰柔性环瓣环成形术的所有患者进行了随访，直至1987年12月。85例患者共植入了87个柔性环。44.8%的患者同时进行了主动脉和/或三尖瓣手术。住院死亡2例（2.3%），晚期死亡3例（3.5%）。10例患者失访，均在术后2年内。发生血栓栓塞事件18例（11例中枢性和7例外周性），1例死亡。13例患者需要再次手术（17.8%），其中11例进行了瓣膜置换，2例进行了新的柔性环瓣环成形术，均无死亡。再次手术的原因包括反流8例（10.9%）和狭窄5例（5.8%）。病变为反流时，两次手术的平均间隔时间为20.6个月；病变为狭窄时，平均间隔时间为87.8个月。可以得出结论，在这群以风湿性病变为主的患者中，二尖瓣重建手术在12至13年的随访中再次手术发生率接近18%。
