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二尖瓣修复:法国式矫正与美式矫正

Mitral Valve Repair: The French Correction Versus the American Correction.

作者信息

Schubert Sarah A, Mehaffey James H, Charles Eric J, Kron Irving L

机构信息

Division of Thoracic and Cardiovascular Surgery, Department of Surgery, University of Virginia, 1215 Lee Street, Box 800679, Charlottesville, VA 22908, USA.

Department of Surgery, University of Virginia, Box 800709, Charlottesville, VA 22908, USA.

出版信息

Surg Clin North Am. 2017 Aug;97(4):867-888. doi: 10.1016/j.suc.2017.03.009.

Abstract

Degenerative mitral valve disease causing mitral regurgitation is the most common organic valve pathology and is classified based on leaflet motion. The "French correction" mitral valve repair method restores normal valvular anatomy with extensive leaflet resection, chordal manipulation, and rigid annuloplasty. The American correction attempts to restore normal valve function through minimal leaflet resection, flexible annuloplasty, and use of artificial chordae. These differing methods of mitral valve repair reflect an evolution in principles, but both require understanding of the valve pathology and correction of leaflet prolapse and annular dilatation. Adhering to those unifying principles and ensuring that no patient leaves the operating room with significant persistent mitral regurgitation produces durable results and satisfactory patient outcomes.

摘要

导致二尖瓣反流的退行性二尖瓣疾病是最常见的器质性瓣膜病变,可根据瓣叶运动进行分类。“法国矫正法”二尖瓣修复方法通过广泛的瓣叶切除、腱索处理和刚性瓣环成形术来恢复正常的瓣膜解剖结构。美国矫正法则试图通过最小限度的瓣叶切除、柔性瓣环成形术和使用人工腱索来恢复正常的瓣膜功能。这些不同的二尖瓣修复方法反映了原则上的演变,但两者都需要了解瓣膜病变并纠正瓣叶脱垂和瓣环扩张。坚持这些统一的原则,并确保没有患者在离开手术室时仍存在明显的持续性二尖瓣反流,才能产生持久的效果和令人满意的患者预后。

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