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部分瓣环成形环在功能性缺血性二尖瓣反流修复中的应用

Partial Annuloplasty Rings in the Repair of Functional Ischemic Mitral Regurgitation.

作者信息

Kunwar Muhammad Aqeel, Muhammad Imran, Khan Muhammad N, Sumreen Begum, Soomro Najia A, Naseeb Khalid, Imran Ali

机构信息

Cardiac Surgery, National Heart Institute, Kuala Lumpur, MYS.

Institute of Medical Technology, Dow University of Health Sciences, Karachi, PAK.

出版信息

Cureus. 2020 Jun 3;12(6):e8419. doi: 10.7759/cureus.8419.

DOI:10.7759/cureus.8419
PMID:32642335
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7336716/
Abstract

Background Acute myocardial infarction (MI) is the leading cause of worldwide cardiac morbidities and mortalities. Mitral regurgitation (MR) is a common complication of MI. The severity of ischemic MR (IMR) can range widely, both clinically and hemodynamically. Mitral valve (MV) repair by lifting annuloplasty is a surgical procedure used to correct the pathology of IMR. The immediate outcomes of this technique have not yet been determined. The present study, therefore, evaluated the immediate results of MV annuloplasty performed to complement MV repair in patients with IMR. Methodology All adult patients with IMR who underwent lifting posterior mitral annuloplasty (LPMA) plus concomitant coronary artery bypass grafting (CABG) were included. Immediate outcomes were evaluated by transesophageal color Doppler echocardiography. The frequency of successful outcomes was compared in patients with different baseline characteristics. Results Posterior mitral annuloplasty was successful in 93.1% of patients, including in 92.8% of men and 94.1% of women. The percentages of successful immediate outcomes differed significantly in patients with and without diabetes and hypertension, and in patients with two- and three-vessel disease. Conclusion LPMA resulted in a high percentage of successful immediate outcomes in patients with IMR. Further studies should compare rates of immediate, intermediate, and late outcomes of this technique.

摘要

背景

急性心肌梗死(MI)是全球心脏疾病发病和死亡的主要原因。二尖瓣反流(MR)是MI的常见并发症。缺血性二尖瓣反流(IMR)的严重程度在临床和血流动力学方面差异很大。通过提升瓣环成形术进行二尖瓣(MV)修复是一种用于纠正IMR病理的外科手术。该技术的即时效果尚未确定。因此,本研究评估了在IMR患者中进行MV瓣环成形术以辅助MV修复的即时结果。

方法

纳入所有接受后二尖瓣环提升成形术(LPMA)并同时进行冠状动脉旁路移植术(CABG)的成年IMR患者。通过经食管彩色多普勒超声心动图评估即时结果。比较不同基线特征患者的成功结果频率。

结果

93.1%的患者后二尖瓣环成形术成功,其中男性为92.8%,女性为94.1%。有糖尿病和无糖尿病患者、有高血压和无高血压患者以及双支血管病变和三支血管病变患者的即时成功结果百分比存在显著差异。

结论

LPMA在IMR患者中产生了高比例的即时成功结果。进一步的研究应比较该技术的即时、中期和长期结果发生率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/855e/7336716/1f0341a66d38/cureus-0012-00000008419-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/855e/7336716/1f0341a66d38/cureus-0012-00000008419-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/855e/7336716/1f0341a66d38/cureus-0012-00000008419-i01.jpg

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本文引用的文献

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J Biomech. 2018 Jun 25;75:58-66. doi: 10.1016/j.jbiomech.2018.04.043. Epub 2018 May 3.
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Early Diagnosis of Cardiovascular Diseases in Workers: Role of Standard and Advanced Echocardiography.工人的心血管疾病早期诊断:标准和高级超声心动图的作用。
Biomed Res Int. 2018 Jan 16;2018:7354691. doi: 10.1155/2018/7354691. eCollection 2018.
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Functional Mitral Regurgitation: Imaging Insights, Clinical Outcomes and Surgical Principles.
功能性二尖瓣反流:影像学见解、临床结果和手术原则。
Prog Cardiovasc Dis. 2017 Nov-Dec;60(3):351-360. doi: 10.1016/j.pcad.2017.11.006. Epub 2017 Nov 21.
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Surgery for rheumatic mitral valve disease in sub-saharan African countries: why valve repair is still the best surgical option.撒哈拉以南非洲国家风湿性二尖瓣疾病的手术治疗:为何瓣膜修复仍是最佳手术选择。
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An Automated Expanded Polytetrafluoroethylene Suturing and Coaxial Fastener System for Mitral Chordae Replacement: Strength, Feasibility, and Healing.一种用于二尖瓣腱索置换的自动化膨体聚四氟乙烯缝合与同轴紧固件系统:强度、可行性及愈合情况
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J Cardiothorac Surg. 2015 Nov 13;10:164. doi: 10.1186/s13019-015-0350-6.
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Lifting posterior mitral annuloplasty for enhancing leaflet coaptation in mitral valve repair: midterm outcomes.二尖瓣修复术中行后瓣环成形术增强瓣叶对合:中期结果。
Ann Cardiothorac Surg. 2015 May;4(3):249-56. doi: 10.3978/j.issn.2225-319X.2015.04.03.
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