应用复合二尖瓣成形技术治疗复杂性二尖瓣关闭不全的效果研究

《应用复合二尖瓣成形技术治疗复杂性二尖瓣关闭不全的效果研究》由会员上传分享，免费在线阅读，更多相关内容在行业资料-天天文库。

1、390·上海交通大学学报(医学版)·JOURNALOFSHANGHAIJIAOTONGUNIVERSITY(MEDICALSCIENCE)Vo1．36No．3Mar2016论著临床研究应用复合二尖瓣成形技术治疗复杂性二尖瓣关闭不全的效果研究马文锐，张卫，叶伟，石哺上海交通大学附属胸科医院心血管外科，上海200030[摘要]目的研究应用多种二尖瓣成形技术于同一患者对复杂性二尖瓣关闭不全的纠治效果。方法对患有中度以上复杂性二尖瓣关闭不全的76例患者，复合应用两种及以上成形技术进行纠治。术中行经食管超声心动图(TEE)检测二尖瓣关闭情况；术后出

2、院前行心脏彩色超声复测瓣膜反流情况；随访近中期二尖瓣关闭情况及左心功能相关参数。结果术中TEE检测结果提示，应用复合二尖瓣成形技术后二尖瓣关闭优良率达97．37％(74／76)。出院前心脏彩色超声结果与术中TEE结果相同。随访6～72个月，二尖瓣关闭优良率达93．42％(71／76)，左室射血分数较术前明显提高，左室舒张末内径较术前明显缩短。结论复合应用多种二尖瓣成形技术是纠治复杂性二尖瓣关闭不全的有效方法，所复合术式的选择视患者瓣膜的病变情况与术者对各种技术的熟练掌握程度而定。[关键词]复合二尖瓣成形技术；复杂性二尖瓣关闭不全；疗效[D

3、OI]10．3969／j．issn．1674培115．2016．03．015[中图分类号]R654．2[文献标志码]AStudyontheeficacyofcombinedmitralvalverepairtechniquesintreatingcomplexmitralinsuficiencyMAWen—rui，ZHANGWei，YEWei，SHIWeiDepartmentofCardiovascularSurgery，ShanghaiChestHospital，ShanghaiJiaoTongUniversity，Shanghai20

4、0030，China【Abstract]ObjectiveToinvestigatethetherapeuticeficacyofusingmultiplemitralvalverepairtechniquesintreatingpatientswithcomplexmitralinsuficiency．MethodsTwoormorerepairtechniqueswereusedfortreating76patientswithmoderateorseveremitralregurgitation．Theclosureofmitral

5、valvewasexaminedperioperativelyby七ransesophagea1echocardiography(TEE)andvalveregurgitationwasexaminedbytransthoracicechocardiographyfTTE1beforedischarge．Theclosureofmitralvalveandrelevantleftheartparametersinshortandmediumtermswerefollowedup．ResultsTheperioperativeTEEresu

6、ltsshowedthattheclosureofmitralvalvein97．37％(74／76)ofpatientsreachedsatisfactoryoutcomeafterusingcombinedrepairtechniques．TTEresultsbeforedischargewereconsistentwithTEEresults．6—72monthsoffollow—upshowedthattheclosureofmitralvalvein93．42％(71／76)ofpatientsreachedsatisfacto

7、ryoutcomewithsignificanthigherleftventricularejectionfractionsandlowerleftventricularenddiastolicdiameterscomparedwithpreoperativedata．ConclusionCombinedmitralvalverepairtechniquesareeficientfortreatingcomplexmitralinsuficiencyandthechoiceofcombinedsurgicalprocedureshould

8、bebasedOnpathologicalchangesinpatientvalvesandsurgeons’masteryofrepairtechniques．【Keywords】combi