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[腱索断裂致二尖瓣关闭不全128例外科手术系列报道]

[A surgical series of 128 cases of mitral insufficiency caused by chordae tendineae rupture].

作者信息

Dubost C, Carpentier A, Piwnica A, d'Allaines C, Blondeau P, Soyer R, Eisenmann B

出版信息

Arch Mal Coeur Vaiss. 1975 Jan;68(1):29-34.

PMID:804873
Abstract

In relation with 128 cases of surgical operation for mitral incompetence through ruptured chordae tendinae, the aetiological, anatomical and clinical characteristics of these cases were described. Bacterial endocarditis and spontaneous rupture were present in 77 percent of cases. In 94.4 percent of the cases, the patient coming to operation was in a high functional class (class III and IV of the NYHA). Operation included valve replacement in 100 cases (by a Starr-Edwards prosthesis), while the mitral valve was preserved in 28 patients. The conservative operation presently performed combined the resection-suture of the deinserted area and a reconstitutive valvuloplasty over a Carpentier's ring. Results of this surgery are good in more than 90 percent of the cases.

摘要

针对128例因腱索断裂导致二尖瓣关闭不全而进行外科手术的病例,描述了这些病例的病因、解剖学和临床特征。77%的病例存在细菌性心内膜炎和自发性断裂。94.4%的手术患者心功能分级较高(纽约心脏协会III级和IV级)。100例手术采用瓣膜置换术(使用斯塔尔-爱德华兹人工瓣膜),28例患者保留了二尖瓣。目前进行的保守手术包括对腱索附着处切除缝合以及在卡彭蒂埃环上进行瓣膜成形修复。该手术90%以上的病例效果良好。

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