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时间:2019-06-20
《二尖瓣人工腱索移植术的近中期疗效》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、万方数据·2730主堡匡堂盘查!!!!生!旦!!旦筮!!鲞箜!!翅盟!!!坠盟』g!i塑:!!P!!里迪!!!:!!!j:!!!:!!:堕!:丝二尖瓣人工腱索移植术的近中期疗效韩劲松王辉山尹宗涛韩宏光【摘要】目的总结二尖瓣人工腱索移植术的近中期疗效。方法沈阳军区总医院心血管外科于2009年1月—2010年1月,应用人工腱索移植术治疗二尖瓣脱垂并关闭不全50例,随访48例(96%)共3~4年,复查超声心动图,测量左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)、左心房内径(LAD)、左心室射血分数(LVEF)等,与术前进行比较。结果全组围手术期无死亡。
2、出院时患者心功能均为I级或Ⅱ级。随访1例因术后13个月发生大面积脑梗死死亡。余47例均存活,无再次手术患者,NYHA心功能分级I级45例,Ⅱ级2例。与术前比较,术后3年超声心动图显示LVEDD、LVESD、LAD均明显减少(均P<0.01),LVEF明显增加(0.55±0.06比0.67±0.07,P<0.01),反流束面积/左房面积明显减少(39.5%±9.7%比5.6%±0.1%,P<0.01)。未发现人工腱索断裂或劈裂。结论二尖瓣人工腱索移植术近中期疗效良好。【关键词】二尖瓣脱垂;二尖瓣闭锁不全;心脏外科手术;人工腱索Earlyandmidtermoutcome
3、sofartificialchordaetransplantinmitralvalverepairHANJin.song.确AhGHui—shan,Yl^Zong—tao.HA烈Hong—guan昏DepartmentofCardiovascularSurgery.GeneralHospitalofShenyangMilitaryCommand,Shenyang110016.ChinaCorrespondingauthor:黝J7、7G执i—shan,Emaif:hu蠡hanwang@hotmaiLcom【Abstract】ObjectiveTosummarizeth
4、eearlyandmidtermoutcomesofartificialchordaetransplantinmitralvalverepair.MethodsAtotalof50patientsunderwentmitralvalverepairwithartificialchordaetransplantfromJanuary2009toJanuary2010inGeneralHospitalofShenyangMilitaryCommand.Follow.uDwasconductedon48cases(96%)for3—4years.ResultsNoearly
5、postoperativemortalityoccurred.A11caseshadcardiacftlnctionNewYorkHeartAssociation(NYHA)gradeI/11atdischarge.Among48cases.onediedofcerebralinfarctionafter13monthsandtheremindersurvivedandnooneunderwentreoperation.Amongsurvivors,45caseswereincardiacfunctionNYHAgradeIandanother2ingradeⅡ.Ec
6、hocardiographyshowedthatpostoperative3yearsleftatrialdiameter.1eftventficularend.diastolicdimension.1eftventricularend—systolicdimensionandtheratioofregurgitationbeamareaandleftatrialareaweresignificantlysmallerthanthosepreoperativeones(39.5%±9.7%VS5.6%±0.1%.P<0.01)andleftventficulareje
7、ctionfractionincreasedmarkedly(0.554-0.06VS0.67±0.07.P<0.01).Therewasnoinstanceofartifieialchordaerupture.ConclusionGore.TexartificialchordaetransplantiSasafeandeffectivetechniqueinmitralvalverepairwithexcellentearlyandmidtermoperativeoutcomes.【Keywords】Mitralvalveprolapse;Mitr
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