Karlson K J, Ashraf M M, Berger R L
Division of Cardiovascular Surgery, New England Deaconess Hospital, Boston, MA.
Ann Thorac Surg. 1988 Nov;46(5):590-7. doi: 10.1016/s0003-4975(10)64712-1.
A survey of the English language literature revealed 125 cases of left ventricular rupture following mitral valve replacement. In ten larger series, the incidence averaged 1.2%. Most of the ruptures were attributed either to technical maneuvers in the operation or to stretch injury produced by the untethering of the left ventricle through removal of the mural leaflet of the mitral valve. Preventive measures include modifications in operative techniques, containing pressure-volume work by the left ventricle, and probably retention of the posterior mitral leaflet. Surgical repair of the rupture with and without the aid of cardiopulmonary bypass resulted in 50% and 7% survival, respectively. With the use of cardiopulmonary bypass, external repair was followed by a 67% survival and the internal approach, by a 27% survival.
一项对英文文献的调查显示，二尖瓣置换术后发生左心室破裂的病例有125例。在十个较大的系列研究中，其发生率平均为1.2%。大多数破裂归因于手术中的技术操作，或因切除二尖瓣壁叶使左心室松解所产生的牵张损伤。预防措施包括改进手术技术、控制左心室的压力-容量负荷，以及可能保留二尖瓣后叶。在有或没有体外循环辅助的情况下对破裂进行手术修复，生存率分别为50%和7%。使用体外循环时，外部修复后的生存率为67%，内部修复后的生存率为27%。
