Hagihara H, Kitamura S, Kawachi K, Morita R, Taniguchi S, Fukutomi M, Kawata T, Hasegawa J, Yoshida Y
Department of Surgery III, Nara Medical College, Japan.
Surg Today. 1995;25(4):338-42. doi: 10.1007/BF00311257.
The benefits of performing left atrial plication during mitral valve surgery for patients with a giant left atrium were evaluated by analyzing the short- and long-term surgical results and changes in the left atrial dimension (LAD) and respiratory function of 30 patients. Of the 30 patients, 2 (7%) died of multiple organ failure on postoperative days 26 and 117, but no other deaths occurred during the mean follow-up of 5.9 +/- 2.1 years. Valve thrombosis was observed in one patient and cerebral complications with no residual deficit were observed in two patients, with a 9-year event-free rate of 87 +/- 7%. The LAD decreased significantly from 69.0 +/- 8.5 mm to 53.7 +/- 9.1 mm (P < 0.01) shortly after surgery, and this decreased was maintained even 5 years after surgery (53.3 +/- 11.4 mm). The cardiothoracic ratio decreased from 74.8 +/- 8.3% to 62.8 +/- 9.0% (P < 0.01) and the vital capacity of the lungs increased from 71.1 +/- 18.0% to 82.9 +/- 22.2% (P < 0.01). Thus, we conclude that performing left atrial plication during mitral valve surgery is safe and effective for patients with giant left atrium.
通过分析30例巨大左心房患者二尖瓣手术中进行左心房折叠术的短期和长期手术结果以及左心房内径（LAD）和呼吸功能的变化，评估该手术的益处。30例患者中，2例（7%）分别于术后第26天和117天死于多器官功能衰竭，但在平均5.9±2.1年的随访期间未发生其他死亡病例。观察到1例患者发生瓣膜血栓形成，2例患者出现无残留神经功能缺损的脑部并发症，9年无事件发生率为87±7%。术后不久，LAD从69.0±8.5mm显著降至53.7±9.1mm（P<0.01），甚至在术后5年仍维持下降状态（53.3±11.4mm）。心胸比率从74.8±8.3%降至62.8±9.0%（P<0.01），肺肺活量从71.1±18.0%增至82.9±22.2%（P<0.01）。因此，我们得出结论，对于巨大左心房患者，二尖瓣手术中进行左心房折叠术是安全有效的。
