【摘要】 目的 明确心尖入路经导管瓣中瓣技术治疗二尖瓣生物瓣置换术后二尖瓣衰败的临床效果。方法 回顾性分析2021年7月至2021年8月我院2例男性患者二尖瓣生物瓣置换术后因二尖瓣生物瓣衰败接受心尖入路经导管二尖瓣瓣中瓣技术治疗患者的临床资料。结果 二尖瓣瓣膜置换术后生物瓣膜衰败后二次开胸换瓣是导致心外科手术高风险的重要因素。经心尖导管内瓣膜置入对高危、高龄、二次换瓣患者可以降低手术风险，获得良好的治疗结果。天津市胸科医院采用国产瓣膜应用经心尖介入二尖瓣技术成功救治2例二尖瓣置换术后生物瓣衰败的患者，手术恢复效果满意，与术前患者的二尖瓣峰值流速和跨瓣压差相比均显著降低，术后患者二尖瓣反流消失，几乎无瓣周漏，左室舒末期内径缩小，三尖瓣反流明显减少，术后无左室流出道梗阻，患者的血流动力学得到有效改善，心功能明显改善。结论 经心尖经导管二尖瓣瓣中瓣置入被公认是治疗高危二尖瓣疾病的有效方法，在二尖瓣置换术后生物瓣衰败后需要再次外科手术的高危患者中采用国产瓣膜行瓣中瓣介入手术不失为一种好的选择。更多还原

【Abstract】 Objective To evaluate the clinical effect of mitral valve decay after biological valve replacement through apical approach. Methods A retrospective analysis was performed on the clinical data of 2male patients who were treated with mitral midvalve via apical approach for mitral bivalve decay after mitral bivalve replacement in our hospital from July 2021 to August 2021. Result Secondary thoracotomy after biological valve failure after mitral valve replacement is an important factor leading to high risk of cardiac surgery.Transapical intraductal valve placement can reduce the risk of surgery for high-risk, elderly patients with secondary valve replacement and obtain good treatment results. Tianjin chest hospital is made of domestic valve application after intervention successfully treated 2 cases of mitral valve technology nowadays, biological disc decline after mitral valve replacement patients with satisfactory recovery effect and patients with preoperative peak flow velocity of mitral valve and cross valve differential pressure were significantly lower than that of postoperative patients with mitral regurgitation in disappear, almost no valve leakage, zhou left ventricular late shu diameter smaller, Tricuspid regurgitation was significantly reduced, and there was no left ventricular outflow tract obstruction after surgery. The patient’s hemodynamics was effectively improved and cardiac function was significantly improved. Conclusion Transapical transcatheter mitral midvalve implantation has been recognized as an effective method for the treatment of high-risk mitral valve diseases, and the use of domestic valve midvalve implantation technology can be regarded as a good choice for high-risk patients who need resurgery after the biological valve failure after mitral valve replacement.更多还原