Golubev I S, Grigorian E A
Kardiologiia. 1977 Jan;17(1):49-54.
A total of 500 patients with mitral stenosis subjected to mitral commissurotomy were examined 1 to 14 years after surgery. Relative tricuspid insufficiency accompanying mitral stenosis was detected preoperatively in 104 patients (20.8%). The authors concluded that it was rationale to undertake mitral commissurotomy in such patients after careful preoperative preparation, and to treat them medically afterwards. The follow-up analysis demonstrated that good results of surgery were achieved in 32 cases (30.8%), satisfactory--in 60 (56.7%), poor--in 11 (10.5%). One patient died after surgery for mitral re-stenosis. A comparison of 2 groups of patients--Group 1 with mitral stenosis and relative tricuspid valve insufficiency, and Group 2 with mitral stenosis alone without tricuspid insufficiency--revealed that the late results were better in Group 1. To maintain the positive effect of surgery in all the cases preventive anti-rheumatism measures should be taken the year round.
对500例行二尖瓣交界切开术的二尖瓣狭窄患者在术后1至14年进行了检查。术前在104例患者(20.8%)中检测到伴有二尖瓣狭窄的相对性三尖瓣关闭不全。作者得出结论,对此类患者在仔细的术前准备后进行二尖瓣交界切开术,并在术后进行药物治疗是合理的。随访分析表明,手术效果良好的有32例(30.8%),满意的有60例(56.7%),差的有11例(10.5%)。1例患者因二尖瓣再狭窄术后死亡。对两组患者进行比较——第1组为二尖瓣狭窄合并相对性三尖瓣关闭不全,第2组为单纯二尖瓣狭窄无三尖瓣关闭不全——结果显示第1组的远期效果更好。为在所有病例中维持手术的积极效果,应全年采取预防性抗风湿措施。