摘要
目的总结二尖瓣Carpentier-Edwards PhysioⅡ成形环在二尖瓣关闭不全患者外科治疗中的应用并评估其治疗效果。方法 2018年6月至2019年7月在昆明医科大学第一附属医院心脏外科接受二尖瓣膜成型手术治疗的18例二尖瓣关闭不全患者,其中8例合并三尖瓣关闭不全者同期行三尖瓣成形术。分别在术前、术后6个月、术后12个月采用经胸壁超声测量LA、LVEDD、LVEF,观察手术前后各项数值变化,评估该二尖瓣成形环的治疗疗效。结果 18例患者中男性8例,平均年龄(46±9)岁。其中Barlow氏病2例,退行性病变4例,其余12例为风湿性病变。18例患者中二尖瓣关闭不全合并三尖瓣关闭不全8例。共置入二尖瓣成形环18枚(Carpentier-Edwards PhysioⅡ),三尖瓣成形环8枚(Edwards MC3)。与术前相比,术后6个月、12个月左房内径(P<0.05)、左室舒张末内径均明显缩小(P<0.05),左室射血分数差异无统计学意义(P>0.05)。结论Carpentier-Edwards PhysioⅡ成形环置入后较术前扩张的左房、左室舒张末内径均明显缩小,心脏重构情况得以缓解。从力学与仿生学角度来看,双马鞍形设计的成形环与二尖瓣环形态和力学特点更为吻合,在治疗二尖瓣关闭不全的同时,能稳定心脏正常解剖构型,但中远期疗效仍有待进一步随访观察。
Objective To summarize and evaluate the effcte of annuloplasty ring(Carpentier-Edwards PhysioⅡ)as an alternative surgical approach to treat mitral valve prolapse.Methods We analyzed 18 patients with mitral valve prolaspe and not closing properly who were treated in our department between June 2018 and July 2019.8 patients with tricuspid insufficiency underwent tricuspid angioplasty.LA,LVEDD and LVEF were measured by transthoracic ultrasound before surgery,6 months and 12 months after surgery.The changes in various values were observed so as to evaluate the effect of treatment.Results Among the 18 subjects,8 were males at the age between(46±9).There were 2 cases of Barlow,4 cases of degenerative diseases and 12 cases of Rheumatic diseases.8 cases had mitral regurgitation accompanied with tricuspid regurgitation.18 carpentier-Edwards PhysioⅡrings were used,and 8 Edwards MC3 rings were used.LA and LVEDD at 6 and 12 months after surgery were reducedCompared to before(P<0.05),and LVEF did not change significantly(P>0.05).Conclusion After the Carpentier-Edwards PhysioⅡwas inserted,the LA and LVEDD inner diameters were significantly reduced,and cardiac remodeling was relieved.From the perspective of mechanics and bionics,the shape of the double saddle ring fits better into the physiological state mitral valve ring.While treating mitral regurgitation,it can stabilize the normal anatomy of the heart.We will follow up and analyze the effect chronically.
作者
梅松
蒋雯
白向锋
陶杰
王文杰
李家宇
MEI Song;JIANG Wen;BAI Xiang-feng;TAO Jie;WANG Wen-jie;LI Jia-yu(Dept.of Cardiovascular Surgery,The 1st Affiliated Hospital of Kunming Medical University,Kunming Yunnan 650032,China)
出处
《昆明医科大学学报》
CAS
2020年第6期85-88,共4页
Journal of Kunming Medical University
基金
云南省科技厅-昆明医科大学应用基础研究联合专项基金资助项目[2017FE468(-194)]。
