【摘要】 目的总结先天性心脏病房室间隔缺损二尖瓣关闭不全的二尖瓣成形手术方法和临床效果。方法84例房室间隔缺损患者中,完全性房室间隔缺损9例、过度性房室间隔缺损21例、部分性房室间隔缺损54例。二尖瓣关闭不全的主要病理改变为瓣叶裂隙84例、瓣环扩大41例。二尖瓣成形方法为瓣叶裂隙缝合78例、交界环缩26例、瓣环环缩7例、双孔法2例等。术中左心室注水观察、评价成形后二尖瓣反流程度,脱离体外循环后食管超声心动图观察成形结果。结果全组死亡1例,1例因术后血尿行二尖瓣置换术。术后门诊随访,二尖瓣反流0￣Ⅰ级反流58例,Ⅱ级11例;术后随访,左心房、左心室缩小,与术前比较差别有统计学意义。结论房室间隔缺损二尖瓣关闭不全除瓣叶裂隙需要缝合外,还要矫正扩大的瓣环,术中注水试验和食管超声能为判断手术效果提供帮助。更多还原

【Abstract】 Objective To explore operative methods of mitral valve valvuloplasty concomitant with atrialventricular septal defects and outcomes. Methods 84 patients underwent mitral valve repair procedure. The surgery methods included correcting defect of leaflets(in 78 cases), closing commissure (in 26 cases), annuloplasty (in 7 cases). Results One case had mechanical valve replacement and 1 case dead of low heart output. Left ventricular and diastolic diameter (LVEDD) and left atrium diameter decreased significantly[from (41.0±1.9)mm to (38.9±1.0)mm, P<0.05 and from (35.6±1.0)mm to (29.0±8.2)mm,P<0.001]. Conclusion Closing commissure are equally important as correcting defect of leaflets in the surgery of mitral valve regurgitation concomitant with atrialventricular septal defects.更多还原