欢迎来到天天文库
浏览记录
ID:20172624
大小:4.13 MB
页数:35页
时间:2018-10-10
《缺血性二尖瓣关闭不全的治疗(英文)》由会员上传分享,免费在线阅读,更多相关内容在教育资源-天天文库。
1、ISCHEMICMITRALREGURGITATION首都医科大学附属北京安贞医院心外科甘辉立PURPOSEIsvalverepairsuperiortovalvereplacementforischemicmitralregurgitation?DEFINITIONPreviousMINormalMVMECHANISMRupturedpapillarymuscleInfarctedpapillarymuscleFunctionalFunctionalPapInfarctPapRuptureMECHA
2、NISM27%8%65%REGURGITANTJETCentralPosteriorComplexAnterior7%58%15%20%Anterior40%Inferior73%Posterior63%Septal42%Lateral44%WALLMOTIONABNORMALITIESMITRALVALVEPROCEDURE39785REPAIRTECHNIQUES%Annuloplasty98Papmuscleshortening10Chordalshortening8Leafletresecti
3、on5Papmusclereimplant2ANNULOPLASTYSIZESIZE(mm)OPERATIVEMORTALITY8%26%P<.0001OPERATIVEMORTALITYReplacement26%Repair8%P<.0001SURVIVAL%Years716049YearsSURVIVAL%Years605446Years746150RepairReplacementSURVIVALPaprupturePapinfarctFunctionalMR%YearsRISKFACTORS
4、AdvancedAgeHigherNYHAfunctionalclassGreaterLVdysfunctionRenaldysfunctionAtrialfibrillationMitralvalvereplacementRISKFACTORSAFTERMITRALREPAIRComplexregurgitantjetLateralinfarctBovinepericardialannuloplastyNoITAgraftREPAIRvsREPLACEMENT%MATCHEDQUINTILESI%
5、III–V%EmergentStatus330.3FunctionalMR1686RupturedPap4813InfarctedPap382ITAGraft1655Repair4196002040608010001234567020406080100012345670204060801001234567SURVIVAL:MATCHEDQUINTILESIIIIII-VRepairReplacePREDICTEDSURVIVALrepairreplacement%Yearsreplacementr
6、epairPREDICTEDSURVIVAL%YearsDifferenceRepairBenefitReplaceBenefit7YEARSURVIVAL%REPAIRFAILURE959288%YearsCONCLUSIONSSurvivalispoorMostbenefitfromrepairInsickestpatients,survivalsimilarwithrepairandreplacementREMAININGQUESTIONSIntermittentischemicMR2+isch
7、emicMRatCABGChordalpreservationatMVRMechanismsofischemicMR
此文档下载收益归作者所有