Carpentier A, Relland J, Deloche A, Fabiani J N, D'Allaines C, Blondeau P, Piwnica A, Chauvaud S, Dubost C
Ann Thorac Surg. 1978 Oct;26(4):294-302. doi: 10.1016/s0003-4975(10)62895-0.
Prolapsed leaflet is the result of ruptured chordae, elongated chordae, or ruptured papillary muscle. Various techniques adapted to each of these lesions were developed, and repair of 213 prolapsed mitral valves was performed between 1969 and 1977. There were 109 patients with ruptured chordae treated by quadrangular resection of the prolapsed leaflet; 103 patients with elongated chordae were treated by either a "sliding plasty" of the papillary muscle or a "shortening plasty" of the chordae; and 1 patient with ruptured papillary muscle was treated by reimplantation. The great majority of patients had an associated annular dilatation or deformation requiring the use of a Carpentier ring to remodel the annulus and reinforce the repair. The operative mortality was 4% and the late mortality, 3%. There were 6 reoperations, 3 of which occurred within 1 year. Thromboembolic complications occurred in only 1 patient (0.5%), even though the majority of patients received no anticoagulation treatment. Actuarial curves demonstrated a 91% survival at 8 years.
瓣叶脱垂是腱索断裂、腱索延长或乳头肌断裂的结果。针对这些病变分别开发了各种技术，1969年至1977年间对213例二尖瓣脱垂进行了修复。109例腱索断裂患者采用脱垂瓣叶四边形切除术治疗；103例腱索延长患者采用乳头肌“滑动成形术”或腱索“缩短成形术”治疗；1例乳头肌断裂患者采用再植入治疗。绝大多数患者伴有瓣环扩张或变形，需要使用Carpentier环重塑瓣环并加强修复。手术死亡率为4%，晚期死亡率为3%。有6例再次手术，其中3例在1年内发生。尽管大多数患者未接受抗凝治疗，但血栓栓塞并发症仅发生在1例患者（0.5%）。精算曲线显示8年生存率为91%。
