Perier P, Stumpf J, Clausnizer B, Hacker R
Herz- und Gefässklinik Bad Neustadt/Saale.
Herz. 1996 Jun;21(3):166-71.
Between October 1988 and December 1993, 433 patients with mitral valve insufficiency underwent mitral valve repair. Patient's age ranged from 13 to 82 years (mean age 59.5 years). Mitral valve insufficiency was due to degenerative disease in 192 patients (44%), ischemic disease in 102 (23%), rheumatic disease in 76 (18%) and other causes in 63 patients (15%). Most of the patients (337) were in functional class III or IV. The patients were divided into 3 functional groups: type I (normal leaflet motion) 141 patients (33%), type II (leaflet prolapse) 265 patients (61%) and type III (restricted leaflet motion) 27 patients (6%). Two patients were lost to follow-up for a total follow-up of 761 patients per year. The operative mortality was 2.5% for the total group, 0.4% for the group with isolated mitral valve insufficiency, 7.5% for the group with mitral valve repair associated with coronary artery bypass grafting and 2.9% for the group associated with tricuspid valve repair. At the time of the discharge, 71% of the patient at Doppler echocardiography showed no mitral regurgitation, 25.5%, 3% and 0.5% showed a mitral regurgitation grade 1,2 or 3 respectively. The 5-year actuarial survival was 84%. At 5 years, 96% of the patients were free from reoperation, 96% free from thromboembolism and 93% free from bleeding complications. Among the survivors 93% of the patients were in functional class I or II.
1988年10月至1993年12月期间，433例二尖瓣关闭不全患者接受了二尖瓣修复术。患者年龄为13至82岁（平均年龄59.5岁）。二尖瓣关闭不全的病因包括：退行性疾病192例（44%），缺血性疾病102例（23%），风湿性疾病76例（18%），其他原因63例（15%）。大多数患者（337例）心功能为Ⅲ级或Ⅳ级。患者分为3个功能组：Ⅰ型（瓣叶活动正常）141例（33%），Ⅱ型（瓣叶脱垂）265例（61%），Ⅲ型（瓣叶活动受限）27例（6%）。2例患者失访，每年总随访761例患者。全组手术死亡率为2.5%，单纯二尖瓣关闭不全组为0.4%，二尖瓣修复联合冠状动脉旁路移植术组为7.5%，联合三尖瓣修复组为2.9%。出院时，71%的患者经多普勒超声心动图检查显示无二尖瓣反流，25.5%、3%和0.5%的患者分别显示二尖瓣反流1级、2级或3级。5年预期生存率为84%。5年时，96%的患者无需再次手术，96%的患者无血栓栓塞，93%的患者无出血并发症。在存活患者中，93%的心功能为Ⅰ级或Ⅱ级。
