二尖瓣人工腱索移植术的近中期疗效

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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