Yagyu K, Furuse A
Department of Thoracic Surgery, University of Tokyo, School of Medicine, Japan.
Kyobu Geka. 1995 Jul;48(8):662-5.
In these 14 years, 54 adult patients, 28 males and 26 females, mean age 49.6 years old, underwent mitral valve repair for mitral regurgitation. Valve lesion consisted of 28 valve prolapse, 23 torn chordae, 4 ischemic lesion, 3 rheumatic changes, and 3 clefts. Valve prolapse near the commissure was repaired by Kay-Reed's annuloplasty in 31 patients. Torn chordae of the posterior leaflet was repaired by quadrangular resection of the leaflet in 21 cases. Commissural valve prolapse by torn chordae was treated by commissural resection and sliding repair of the leaflet in 5 patients. Torn chordae of the anterior leaflet was repaired by small triangular resection of the leaflet with artificial chordae using ePTFE suture or transfer of posterior chordae to the anterior leaflet in 6 cases. Ring annuloplasty was performed in 21 cases. Postoperative echocardiographic examination revealed no regurgitation in 41 patients, mild MR in 10, and moderate MR in 3. One patient died of arrhythmia early postoperatively. Another patient had cerebral infarction 10 months after the operation. No other complication or no late death was experienced.
Early and late results of mitral valve repair for mitral regurgitation was satisfactory. Better long-term results will be expected by the improvement of surgical technique.
在这14年中，54例成年患者（28例男性，26例女性，平均年龄49.6岁）因二尖瓣反流接受了二尖瓣修复术。瓣膜病变包括28例瓣膜脱垂、23例腱索断裂、4例缺血性病变、3例风湿性改变和3例瓣裂。31例患者采用Kay-Reed瓣环成形术修复瓣叶联合处附近的瓣膜脱垂。21例患者采用瓣叶四边形切除术修复后叶腱索断裂。5例患者采用瓣叶联合处切除术及瓣叶滑动修复术治疗瓣叶联合处腱索断裂导致的瓣膜脱垂。6例患者采用瓣叶小三角形切除术加人工腱索（使用ePTFE缝线）或后叶腱索转移至前叶修复前叶腱索断裂。21例患者进行了瓣环成形术。术后超声心动图检查显示，41例患者无反流，10例患者有轻度二尖瓣反流，3例患者有中度二尖瓣反流。1例患者术后早期死于心律失常。另1例患者术后10个月发生脑梗死。未出现其他并发症或晚期死亡。
二尖瓣反流二尖瓣修复术早、晚期效果满意。通过手术技术的改进有望获得更好的长期效果。
