Mitral valve repair: Better than replacement
Mitral valve repair: Better than replacement
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DOI：
10.1136/hrt.2005.076208
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发表时间：
2006-02-01
期刊：
影响因子：
5.7
通讯作者：
Antunes, MJ
中科院分区：
文献类型：
--
作者：
de Oliveira, JMF;Antunes, MJ
对于大多数外科医生来说，二尖瓣修复术已成为手术矫正二尖瓣反流的首选方法。然而，修复的可行性不仅取决于病理，还取决于外科医生和/或团队的经验。对于最常见的后叶中部扇形脱垂的最常见形式，成功率几乎可以达到 100%。尽管如此，二尖瓣修复仍然面临着明显的、有时甚至是痛苦的学习曲线。修复的持久性还取决于病理类型和许多其他因素，包括所使用的技术。自 20 世纪 70 年代诞生以来，二尖瓣修复技术经过了许多修改和改进，使其成为一种更具可预测性和可重复性的方法。取得很大改进的一个领域是缺血性反流，最初被认为难以修复，但现在对此的经验不断增长，结果也有了很大改善。此外，与心肌病相关的反流的治疗也取得了进展，以前被认为是修复的禁忌症。相比之下，风湿病修复术的结果仍然最差，尽管通常发育不全和年轻人口的特征可能仍然比二尖瓣置换术更可取。在这项工作中，我们根据我们的经验和最近的报告分析了二尖瓣修复的最新技术及其结果。
For the majority of surgeons, mitral valve repair has become the method of choice for surgical correction of mitral regurgitation. However, the feasibility of repair depends not only on the pathology but also on the experience of the surgeon and/or team. Success rates may reach almost 100% in the most common form of isolated prolapse of the middle scallop of the posterior leaflet. Nevertheless, mitral repair is still subject to a pronounced, sometimes painful, learning curve. The durability of the repair also depends on the type of pathology and on many other factors, including the technique used.Since its inception in the 1970s, the techniques of mitral valve repair have been the subject of many modifications and improvements which have made it a more predictable and reproducible method. One area where much improvement was made was ischaemic regurgitation, which was initially considered refractory to repair and for which there is now a growing experience and much improved results. Also, advancements have occurred in the treatment of regurgitation related to cardiomyopathy, previously considered a contraindication for repair. By contrast, repair for rheumatic disease still carries the worst results, although the characteristics of the usually underdeveloped and young population may still make it preferable to mitral valve replacement. In this work, we analyse the state of the art of mitral valve repair and its results according to our experience and in the light of recent reports.