Barbero-Marcial M, Riso A, De Albuquerque A T, Atik E, Jatene A
Heart Institute, University of São Paulo Medical School, Brazil.
J Thorac Cardiovasc Surg. 1993 Jul;106(1):105-10.
From June 1987 to October 1991, 12 patients with congenital mitral valve stenosis underwent surgical correction. Their ages ranged from 2 to 74 months. Nine patients were less than 22 months of age. Five patients were in New York Heart Association functional class IV, and seven patients were in class III. In nine, parachute-type mitral stenosis was clearly definite. In three, a complex congenital valvular and subvalvular stenosis was found. Associated anomalies were present in every patient; five had undergone previous operations. Correction of the mitral stenosis was done through an apical left ventriculotomy. The removal of the mitral obstruction starts from below; the papillary muscle was split and the chordae were divided or fenestrated. The commissurotomies were performed from the ventricular aspect of the mitral valve. Associated anomalies were corrected simultaneously. The operative mortality rate was zero. There was one late death, which was unrelated to cardiovascular status. The echocardiographic serial postoperative studies (up to 52 months) showed no significant residual mitral stenosis and normal global and regional function of the left ventricle in all but one patient.
1987年6月至1991年10月，12例先天性二尖瓣狭窄患者接受了手术矫正。他们的年龄从2个月至74个月不等。9例患者年龄小于22个月。5例患者属于纽约心脏协会心功能IV级，7例患者属于III级。9例患者明确为降落伞型二尖瓣狭窄。3例患者发现有复杂的先天性瓣膜及瓣膜下狭窄。每位患者均伴有其他异常；5例患者曾接受过手术。二尖瓣狭窄的矫正通过左心室心尖切开术进行。二尖瓣梗阻的解除从下方开始；乳头肌劈开，腱索切断或开窗。二尖瓣交界切开术从二尖瓣的心室面进行。同时矫正相关异常。手术死亡率为零。有1例晚期死亡，与心血管状况无关。术后系列超声心动图研究（长达52个月）显示，除1例患者外，所有患者均无明显残余二尖瓣狭窄，左心室整体及局部功能正常。
