【摘要】 目的　介绍瓣膜修复手术治疗儿童先天性二尖瓣关闭不全的经验。方法　 8例二尖瓣脱垂伴腱索延长的患者 ,梯形切除脱垂的瓣叶部分并将切缘缝合。 4例延长的腱索包埋在乳头肌内 ,另 4例过长的腱索则被折叠固定于瓣叶下 ;4例瓣叶裂隙 ,单纯缝合裂隙的游离缘 ,6例患者又作了瓣环成形术以减少残余返流。修复后经二尖瓣向左心室腔加压注入生理盐水。如两瓣叶关闭线平行于瓣环 ,两个瓣叶表面隆起良好 ,则可证明修复结果是良好的。结果　本组无死亡。 10例患儿恢复顺利出院 ,2例出院时心功能Ⅱ级 ,药物治疗 3个月后症状消失。超声心动提示瓣膜活动好。多普勒检查提示 5例仍有微量～少量返流。结论　瓣膜修复技术是治疗儿童先天性二尖瓣关闭不全理想的方法更多还原

【Abstract】 Objective To present our experience with valve repair for congenital mitral valve incompetence in children. Methods In 8 cases of mitral valve prolapse and enlongated chordal tendinae, the prolapsed portion of the leaflet was corrected by rectangular leaflet resection and suture. The elongated chordae were shortened by embedding the excessive length of chordae in the groove made within the anterior aspect of the papillary muscle (4 cases), or by folding and fixing the elongated portion of chorda beneath the leaflet (another 4 cases). In the 4 cases of mitral defect, the free edge of defect was treated by direct suture. Annuloplasty was performed in 6 out of the 12 patients to reduce the residual regurgitation. Saline was injected into the left ventricular cavity through the mitral valve after repairing. The result was judged to be satisfactory if the closure line of the two leaflets was parallel to the annulus and there was a good surface of coaptation between the two leaflets. Results No death occurred in the series. On discharge, 10 patients recovered uneventfully, and the other two, who were in functional Class Ⅱ, continued to receive medical treatment until the symptoms disappeared. Echo and color-Dopplar showed good motion of the mitral valve in all patients and minor to mild regurgitation in 5 patients. Conclusion Valve repair is an effective procedure to treat congenital mitral valve incompetence in children.更多还原