摘要
目的总结对冠心病合并重度缺血性二尖瓣关闭不全外科治疗的经验。方法自2006年1月2009年12月,45例冠心病合并重度缺血性二尖瓣关闭不全（ischemic mitral valve regurgitation,IMR）行冠状动脉旁路移植术时同期行二尖瓣成形术24例,瓣膜置换术21例。男35例,女10例;年龄3274岁[平均（58.46±12.51）岁]。结果围术期死亡2例,死于多器官功能衰竭（multiple organ failure,MOF）。超声心动图检查提示：术后二尖瓣反流面积与术前比较明显下降[（11.80±2.45）cm2和（2.83±0.98）cm2,t=22.80,P=0.00],术后左心室舒张期末内径（left ventricular end diastolic diameter,LVEDD）与术前比较明显减小[（57.61±10.06）mm和（51.84±8.98）mm,t=2.85,P=0.005）]。左心室射血分数（left ventricularejection fraction,LVEF）无明显差异（52.7%±15.4%和53.2%±13.2%,t=0.16,P=0.87）。结论治疗冠心病合并重度缺血性二尖瓣关闭不全,对二尖瓣病变进行必要的外科手术矫正,早期可改善左心室收缩功能。
Objective To summarize the experience with surgical treatment of coronary artery disease with severe ischemic mitral valve regurgitation （IMR）. Methods From January 2006 to December 2009, 45 patients （35 males, 10 females aged 32-74 years） with the diagnosis of coronary artery disease complicated by IMR underwent coronary artery bypass grafting （CABG） combined with mitral valve plasty （MVP, 24 cases） or mitral valve replacement （MVR, 21 cases）. Results Perioperative deaths occurred in 2 cases due to multiple organ failure （MOF）. Echocardiography showed a significant reduction of the mitral regurgitation area （from 11.80±2.45 cm2 to 2.83±0.98 cm2, t=22.80, P=0.00） after CABG combined with mitral valve surgery, with also significantly reduced postoperative left ventricular end diastolic diameter （LVEDD） （from 57.61±10.06 mm to 51.84±8.98 mm, t=2.85, P=0.005）. No significant difference was detected in the left ventricular ejection fraction after the operation [（52.7±15.4）% vs （53.2±13.2）%, t=0.16, P=0.87）]. Conclusion CABG combined with mitral valve surgery can improve early postoperative left ventricular function in patients with ischemic coronary heart disease complicated by severe mitral regurgitation, but further follow-up study is still needed for evaluation of the long-term results
出处
《南方医科大学学报》
CAS
CSCD
北大核心
2011年第6期1072-1074,共3页
Journal of Southern Medical University
基金
广东省科技厅项目(2009B030801033)
