Repairing the mitral valve.
Repairing the mitral valve.
复制标题
修复二尖瓣。
作者：
D. Ott
在本期《循环》杂志中，马约诊所的Enriquez-Sarano和他的同事们为我们理解二尖瓣修复术与二尖瓣置换术的关系做出了宝贵的贡献。在一项优雅而详细的多变量分析中，他们得出结论，二尖瓣修复术是改善手术长期死亡率、射血分数和功能结果的独立预测因素。在对多个变量进行统计学允许后，这些差异得到了证实，这些变量包括手术年份、术前射血分数、年龄、性别、术前纽约心脏协会分级、充血性心力衰竭、房颤、肾脏状态、血压和伴随的冠状动脉旁路手术。
虽然心血管医生已经直观地假设了这一结论，特别是在过去十年中，随着瓣膜修复技术的改进，以前的研究尚未证实二尖瓣修复术比瓣膜置换术产生更好的结果。
In this issue of Circulation , Enriquez-Sarano and his associates1 at the Mayo Clinic have made a valuable contribution to our understanding of mitral valve repair in relation to mitral valve replacement. In an elegant and detailed multivariate analysis, they conclude that mitral valve repair is an independent predictor of improved operative long-term mortality, ejection fraction, and functional result. These differences were confirmed after statistical allowance for multiple variables, including year of surgery, preoperative ejection fraction, age, sex, preoperative New York Heart Association classification, presence of congestive heart failure, atrial fibrillation, renal status, blood pressure, and concomitant coronary artery bypass surgery.
While this conclusion had been assumed intuitively by cardiovascular physicians, particularly during the last decade as the techniques of valve repair improved, previous studies had not confirmed that mitral valve repair produced better outcomes than valve replacement.2 3 The authors of the present study offer a statistically powerful argument on the …