THE EFFECTS OF COMPLETE VERSUS INCOMPLETE MITRAL-VALVE REPAIR IN EXPERIMENTAL MITRAL REGURGITATION
THE EFFECTS OF COMPLETE VERSUS INCOMPLETE MITRAL-VALVE REPAIR IN EXPERIMENTAL MITRAL REGURGITATION
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DOI：
10.1016/s0022-5223(94)70086-9
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发表时间：
1994-02-01
影响因子：
6
通讯作者：
CARABELLO, BA
中科院分区：
文献类型：
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作者：
NAGATSU, M;ISHIHARA, K;CARABELLO, BA
通过我们的闭胸腱索断裂技术，八只狗出现了严重的二尖瓣反流（反流分数 0.75 +/- 0.02）。慢性二尖瓣反流3个月后，所有收缩功能指数均下降。然后尝试修复二尖瓣。与术前值相比，术后反流分数降低；所有八只狗。与此同时，所有狗的前向心输出量均增加，所有狗的肺毛细血管楔压均下降。然而，在一些狗中，尽管进行了修复，但仍存在严重的反流。术后反流率范围为 0% 至 60%。术后残余反流分数与术后心输出量（r = 0.99）、肺毛细血管楔压（r = 0.77）、射血分数（v 3；0.75）以及收缩功能的两个指标——质量校正收缩末期应力体积关系（r = 0.87）和收缩末期硬度（r = 0.93）显着相关。一般来说，当术后返流分数小于30%时，这些参数会恢复到二尖瓣返流前的正常值。研究结束时从心室分离的肌细胞在反流分数低于 30% 时也表现出正常的收缩功能。
Severe mitral regurgitation (regurgitant fraction 0.75 +/- 0.02) was created in eight dogs by our closed-chest chordal rupture technique. After 3 months of chronic mitral regurgitation all indices of contractile function were depressed. Mitral valve repair was then attempted. Postoperative regurgitant fraction was reduced compared with the preoperative value in; all eight dogs. Concomitantly, forward cardiac output increased in all, dogs and pulmonary capillary wedge pressure fell in all dogs. However, in some dogs, significant regurgitation persisted despite repair. Postoperative regurgitant fraction ranged from 0% to 60%. Postoperative residual regurgitant fraction was related significantly to postoperative cardiac output (r = 0.99), pulmonary capillary wedge pressure (r = 0.77), ejection fraction (v 3;0.75), and two indices of contractile function-the mass-corrected end-systolic stress volume relationship (r = 0.87) and end-systolic stiffness (r = 0.93). In general, these parameters returned to their normal values before mitral regurgitation when postoperative regurgitant fraction was less than 30%. Myocytes isolated from the ventricles at the end of study also demonstrated normal contractile function when regurgitant fraction was less than 30%.