【摘要】 目的总结二尖瓣关闭不全外科治疗的经验。方法2001年1月至2007年7月共治疗二尖瓣关闭不全56例,男性25例,女性31例。先天性11例,风湿性3例,非风湿性42例,合并先天性心脏病19例。中度关闭不全18例,中度-重度关闭不全17例,重度关闭不全21例。病变类型:腱索异常37例,如腱索断裂,缺如,一根或多根腱索延长;腱索和乳头肌异常11例;瓣叶发育异常16例;感染性心内膜炎造成的二尖瓣关闭不全3例;瓣环扩大54例。手术方式:单纯腱索短缩13例,乳头肌劈开腱索包埋短缩8例,瓣叶和腱索移植5例,人工腱索再造2例。前瓣叶楔形切除或折叠9例,后叶矩形切除与sliding技术8例,缘对缘技术1例,感染性心内膜炎造成的二尖瓣损害局部修复3例。自制涤纶带环缩2例,二尖瓣环部分环缩38例,置入Duran环16例。结果全组没有手术死亡病例。有2例在手术后8个月和15个月发生二尖瓣返流行二尖瓣瓣膜置换术;二尖瓣功能正常29例(51.79%),残留轻度关闭不全14例(25.00%),残留轻-中度关闭不全11例(19.64%)。随访1～6年(2.3年),结果良好。结论外科修复是治疗二尖瓣关闭不全的主要方法,该方法是安全,有效的,早期效果良好。更多还原

【Abstract】 Objective Summarizing the experience of surgical repair of mitral valve insufficiency.Methods Fifty-six patients with mitral valve insufficiency(MI)were surgically treated in our hospital from January 2001 to July 2007.There were 25 males and 31 females,their ages ranged from 8 months to 59 years.The etiology were congenital heart disease in 11 patioents,rheumatic in 3 patients,and non-rheumatic in 42 patients.Moderate degree insufficiency of mitral valve in 18 patients,moderate to severe degree insufficiency in 17 patients,severe degree insufficiency in 21 patients.Pathological changes type:abnormity of chordae 37 cases including elongation,rupture and defect of chordae,valve heteroplasia in 16 cases,endocarditis in 3 cases.Method of surgical repair:performed shortening of the chordae in 13 cases,the chordae immersed the papillary muscle in 8 cases,leaflet and chordae transferred in 5 cases,the chordae replacement in 2 patients,anterior leaflet incised or collapsed in 9 cases,transpose the chordae attached to a corresponding segment of the posterior leaflet to the floppy anterior leaflet in 5 cases,using sliding procedure in 8 cases,edge to edge procedure in one,repacement Duran ring in 16 cases,using home-made Dacron band in two.Results Follow-up time ranged from 1 years to 6 years(mean 2.3).There are no operative mortality in this group.Two cases underwent mitral valve replacement after 8 and 15 mmonths respectively,due to severe mitral insufficiency.The mitral valve is normal in 29 patients.There are slight insufficiency in 14 cases.The slight to moderate insufficiency is in 11 patients.Conclusion The surgical repair is important technique for mitral insufficiency.This procedure is safe,effective and have good early time results.更多还原