Vrandecic M P, Gontijo B F, Fantini F A, Gutierrez C, Peredo E O, Paula e Silva J A, Barbosa J T, Martins I C, Braga M A, Barbosa M R
Biocor Institute, Belo Horizonte, MG, Brazil.
Eur J Cardiothorac Surg. 1995;9(2):69-73; discussion 74. doi: 10.1016/s1010-7940(05)80020-x.
From March 1992 to August 1993, 50 patients underwent mitral valve replacement with the new heterologous stentless mitral bioprosthesis in our institution. The development of this heart valve substitute, its technique of implantation and the results observed in the first group of 50 patients have had us to review the initial experience. The surgical protocol included an accurate mitral valve complex analysis, adequate valve size selection, attachment of the papillary muscle to the new chordal origin and approximation of the stentless mitral to the patient's annulus. There was one hospital death (2%), not related to the valve or to the technique and four reoperations: two due to endocarditis, one because of a perivalvular leak and one due to a mismatched stentless valve. The late mortality (4%) was not valve-related. The follow-up has shown excellent valve performance with improved left ventricular function in the great majority of the patients. Based on the current analysis, it can be stated that reproducibility of the surgical technique and the excellence of the clinical follow-up may contribute favorably to a better quality of life and longer valve durability in patients requiring mitral heart valve replacement.
1992年3月至1993年8月，我院50例患者接受了新型异种无支架二尖瓣生物假体置换术。这种心脏瓣膜替代品的研发、植入技术以及在首批50例患者中观察到的结果促使我们回顾了初步经验。手术方案包括精确分析二尖瓣复合体、选择合适的瓣膜尺寸、将乳头肌附着于新的腱索起始处以及使无支架二尖瓣与患者瓣环贴合。有1例医院死亡（2%），与瓣膜或技术无关，还有4例再次手术：2例因心内膜炎，1例因瓣周漏，1例因无支架瓣膜不匹配。晚期死亡率（4%）与瓣膜无关。随访显示，绝大多数患者瓣膜功能良好，左心室功能得到改善。基于目前的分析，可以说手术技术的可重复性和良好的临床随访可能有助于提高需要二尖瓣置换术患者的生活质量，并延长瓣膜耐久性。
