Fujiwara T, Murakami T, Inada H, Masaki H, Yoshida H, Fukuhiro Y, Tabuchi A, Ishida A, Katsumura T
Department of Thoracic and Cardiovascular Surgery, Kawasaki Medical School, Kurashiki, Japan.
Kyobu Geka. 1994 Jul;47(8):684-7.
Between 1975 and 1993, 16 of 95 patients who received open mitral commissurotomy for mitral stenosis required reoperation for recurrent mitral lesions with a mean duration of 11 years after the initial operation at Kawasaki Medical School Hospital. The mitral lesions necessitating reoperation involved restenosis in eight, stenoinsufficiency in six and regurgitation in two. In 13 patients, mitral commissure was well separated, and the mitral restenosis and regurgitation were caused by progressions of valvular and subvalvular lesions. Significant tricuspid valve regurgitation was also seen in nine patients, and in seven out of eight patients who were in NYHA functional class III or IV, tricuspid regurgitation of grade 3 was observed. The combined tricuspid regurgitation aggravated the patient's symptoms and became a major risk factor of the reoperation after open mitral commissurotomy.
1975年至1993年间，在川崎医科大学医院，95例因二尖瓣狭窄接受直视二尖瓣交界切开术的患者中有16例因复发性二尖瓣病变需要再次手术，初次手术后的平均时间为11年。需要再次手术的二尖瓣病变包括8例再狭窄、6例狭窄伴关闭不全和2例单纯反流。13例患者二尖瓣交界分离良好，二尖瓣再狭窄和反流是由瓣膜及瓣膜下病变进展所致。9例患者还出现了明显的三尖瓣反流，在纽约心脏协会（NYHA）心功能分级为III或IV级的8例患者中，有7例观察到3级三尖瓣反流。合并的三尖瓣反流加重了患者症状，成为直视二尖瓣交界切开术后再次手术的主要危险因素。
