MITRAL-VALVE ANNULOPLASTY - THE EFFECT OF THE TYPE ON LEFT-VENTRICULAR FUNCTION
MITRAL-VALVE ANNULOPLASTY - THE EFFECT OF THE TYPE ON LEFT-VENTRICULAR FUNCTION
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DOI：
10.1016/0003-4975(89)90426-8
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发表时间：
1989-04-01
影响因子：
4.6
通讯作者：
BURNS, RJ
中科院分区：
文献类型：
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作者：
DAVID, TE;KOMEDA, M;BURNS, RJ
本研究旨在确定刚性环瓣环成形术和柔性环瓣环成形术对继发于二尖瓣退行性疾病的慢性二尖瓣返流患者的左心室功能是否具有相同的影响。25例接受单独二尖瓣修复术并需要瓣膜成形术的患者被随机分为两组：刚性环和柔性环瓣膜成形术。术前1天及术后2 ~ 3个月分别行超声心动图和核素心室造影检查左心功能。两组患者术前左心室功能相似。两组患者术后左室舒张末期内径和容积均明显减小。仅使用柔性瓣成形环的患者左心室收缩末期内径和容积显著降低。使用弹性环的患者通过压力-容积关系评估的左心室收缩功能明显更好（协方差分析p < 0.02），这些患者通过每搏输出量-舒张末期容积关系测量的左心室功能也更好（协方差分析p < 0.05）。这些数据表明，在因二尖瓣退行性疾病继发的慢性二尖瓣反流进行二尖瓣重建后2至3个月，使用柔性瓣成形环的患者比使用刚性瓣成形环的患者具有更好的左心室收缩功能。
This study was undertaken to determine whether rigid-ring annuloplasty and flexible-ring annuloplasty have the same effect on left ventricular function in patients with chronic mitral regurgitation secondary to degenerative disease of the mitral valve. Twenty-five patients who underwent isolated mitral valve repair and required annuloplasty were randomized into two groups: rigid-ring and flexible-ring annuloplasty. Left ventricular function was assessed by echocardiography and radionuclide angiography on the day before operation and 2 to 3 months later. Preoperative left ventricular function was similar in the two groups of patients. Postoperatively, left ventricular end-diastolic diameter and volume decreased significantly in both groups. The left ventricular end-systolic diameter and volume decreased significantly only in patients with a flexible annuloplasty ring. Left ventricular systolic function as assessed by pressure-volume relationships was significantly better in patients with a flexible ring (p < 0.02 by analysis of covariance), and left ventricular performance measured by stroke volume-end-diastolic volume relationships was also better in these patients (p < 0.05 by analysis of covariance). These data indicate that patients with a flexible annuloplasty ring have better left ventricular systolic function than patients with a rigid annuloplasty ring 2 to 3 months after mitral valve reconstruction for chronic mitral regurgitation secondary to degenerative disease of the mitral valve.