Mitral valve repair for degenerative disease with leaflet prolapse: to improve long-term outcomes
Mitral valve repair for degenerative disease with leaflet prolapse: to improve long-term outcomes
复制标题
二尖瓣修复术治疗伴有小叶脱垂的退行性疾病：改善长期结果
DOI：
10.1007/s11748-008-0330-z
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发表时间：
2009
影响因子：
1.2
通讯作者：
S. Nakaji
中科院分区：
文献类型：
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作者：
T. Miura;K. Eishi;Siro Yamachika;K. Hashizume;K. Yamane;S. Taniguchi;K. Tanigawa;Wataru Hashimoto;Tomohiro Odate;S. Nakaji
目的二尖瓣残余返流（MR）是再次手术的危险因素。在这里，我们报告的中期结果二尖瓣修复退行性疾病二尖瓣脱垂，并确定持久repairs.MethodsFrom 1999年4月至2007年9月，116例瓣叶脱垂（59名男性，平均年龄63岁）进行二尖瓣修复，他们包括19个前，67后，23双叶，和7个孤立的连合。平均临床和超声心动图随访时间分别为4.1 ± 2.3和3.3 ± 2.4 years，ResultsAltogether，12例患者在随访期间复发中度或重度MR; 10 12例（83.8%）复发中度或重度MR在1.5年内。早期MR复发的原因是缝合段裂开和人工腱索无效。3年和7年时的无再次手术率分别为95.3% ± 2.0%和91.0% ± 4.7%。术后3年和7年中、重度二尖瓣返流的无复发率分别为90.5% ± 2.9%和83.8% ± 5.9%.ConclusionsThe prevention of dehiscence of the sutured segment and reestablishment of coaptation using artificial chords are impossible to maintain the durability of mitral valve repair for patients with degenerative disease.
PurposeResidual mitral regurgitation (MR) is a risk factor of reoperation. Here we report the midterm results of mitral valve repair for degenerative disease with mitral valve prolapse and identify important factors for durable repair.MethodsFrom April 1999 to September 2007, 116 patients with leaflet prolapse (59 men; mean age 63 years) underwent mitral valve repair; they consisted of 19 anterior, 67 posterior, 23 bileaflet, and 7 isolated commissures. The mean clinical and echocardiographic follow-ups were at 4.1 ± 2.3 and 3.3 ± 2.4 years, respectively.ResultsAltogether, 12 patients showed recurrent moderate or severe MR during the follow-up period; and 10 of the 12 patients (83.8%) had recurrent moderate or severe MR within 1.5 years. Causes of early MR recurrence were dehiscence of sutured segments and ineffectiveness of the artificial chords. The rates of freedom from reoperation at 3 and 7 years were 95.3% ± 2.0% and 91.0% ± 4.7%, respectively. The rates of freedom from recurrent moderate or severe MR at 3 and 7 years were 90.5% ± 2.9% and 83.8% ± 5.9%, respectively.ConclusionsThe prevention of dehiscence of the sutured segment and reestablishment of coaptation using artifi- cial chords are imperative to maintain the durability of mitral valve repair for patients with degenerative disease.
木材工业。39-7。
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