Malyshev Iu I, Tarasov A N, Koltyshev V A
Grudn Khir. 1989 Jan-Feb(1):16-24.
The authors discuss the results of mitral valve replacement in 438 patients with intraoperative selection of the prosthesis and in 77 patients with preoperative selection by means of an original method based on two-dimensional echocardiography. The intraoperative selection proved to be insufficiently effective: in the postoperative periods 13.9 +/- 2.7% of patients had marked signs of lack of correspondence of the prostheses to the size and structure of the left ventricle, which was verified at autopsy or by the findings of intravital catheterization of the heart with ventriculograph. The method of preoperative selection of the prosthesis, which was suggested by the authors, is more effective. It allows implantation of an inadequate prosthesis to be absolutely avoided. The method showed implantation of a ball prosthesis to be contraindicated for 33.7 +/- 5.4% of patients with mitral and mitral-aortic valvular diseases.
作者讨论了438例术中选择人工瓣膜的二尖瓣置换患者以及77例采用基于二维超声心动图的独创方法进行术前选择人工瓣膜的患者的二尖瓣置换结果。术中选择被证明效果不佳：在术后期间，13.9±2.7%的患者有明显迹象表明人工瓣膜与左心室的大小和结构不匹配，这在尸检或心脏活体导管插入术及心室造影检查结果中得到证实。作者提出的术前选择人工瓣膜的方法更有效。它能绝对避免植入不合适的人工瓣膜。该方法表明，对于33.7±5.4%的二尖瓣和二尖瓣 - 主动脉瓣疾病患者，球笼型人工瓣膜植入是禁忌的。
