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二尖瓣手术同时进行主动脉瓣成形术(主动脉瓣叶切片)的远期结果

[Late results of aortic valve plasty (aortic leaflet slicing) simultaneously performed with mitral valve surgery].

作者信息

Hasegawa J, Kitamura S, Kawachi K, Morita R, Seki T, Taniguchi S, Kawata T, Kameda Y, Kaneda K, Kondo Y

机构信息

Department of Surgery III, Nara Medical College, Kashihara, Japan.

出版信息

Nihon Kyobu Geka Gakkai Zasshi. 1993 Apr;41(4):578-83.

PMID:8515155
Abstract

We followed the course of 20 patients who underwent aortic valve plasty (AVP) combined with mitral valve surgery for rheumatic mild aortic valve disease in association with severe mitral valve disease. At operation, all patients underwent aortic leaflet slicing with a knife, and aortic commissurotomy were performed additionally in 10 patients. After surgery, the degree of aortic valve regurgitation and the amplitude of aortic leaflet motion were assessed chronologically, using ultrasound cardiography. One month after surgery, all but one patients showed a reduction in regurgitation to degree I or less. From the third post-operative year, however aortic valve regurgitation tended to increase again. However, the post-operative degree of regurgitation was observed not to be severer than the pre-operative degree of regurgitation, and no patients showed aggravation of aortic valve regurgitation attributable to exacerbation of mitral valve disease. We divided the patients into two groups according to improvement of aortic valve regurgitation. In the group where the degree of regurgitation returned to the pre-operative one, the degree of amplitude of leaflet motion began to reduce from the third post-operative year and was nearly equal to the pre-operative one at the fifth post-operative year. The results of this study can be summarized as follows: 1. From the third post-operative year, aortic regurgitation was aggravated and aortic valve motion amplitude decreased. 2. The number of sliced valve leaflets and incised commissures did not correlate well with the post-operative reduction in regurgitation.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

我们对20例因风湿性轻度主动脉瓣疾病合并严重二尖瓣疾病而接受主动脉瓣成形术(AVP)联合二尖瓣手术的患者进行了随访。手术时,所有患者均用刀进行主动脉瓣叶切片,另外10例患者进行了主动脉瓣交界切开术。术后,使用超声心动图按时间顺序评估主动脉瓣反流程度和主动脉瓣叶运动幅度。术后1个月,除1例患者外,所有患者的反流程度均降至I度或更低。然而,术后第3年起,主动脉瓣反流又有增加趋势。不过,观察到术后反流程度并不比术前严重,且没有患者因二尖瓣疾病加重而出现主动脉瓣反流加重。我们根据主动脉瓣反流的改善情况将患者分为两组。在反流程度恢复到术前水平的组中,瓣叶运动幅度从术后第3年开始减小,术后第5年时几乎与术前相等。本研究结果可总结如下:1. 术后第3年起,主动脉瓣反流加重,主动脉瓣运动幅度减小。2. 瓣叶切片数量和交界切开数量与术后反流减少情况相关性不佳。(摘要截断于250字)

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