542例二尖瓣成形临床疗效及随访结果分析(中英文）PPT.ppt

讨论 风湿性二尖瓣病变 手术难度大 严格把握手术适应症 75％的RHD 病例可成形 本组24例 瓣叶改变轻 2例少－中量反流 无再次手术换瓣 讨论 国内文献报道 闭式扩张术后再手术年限12.5±6.7年，再狭窄率10％－35％ 球囊扩张术结果与闭扩结果相近似 直视下对瓣叶质地较软，无显著卷曲，融合 二尖瓣成形应有良好的效果 结论 经典成形方法适用于大多数病例，效果好 复杂先天性二尖瓣发育不良病例 多种组合 ＋ 灵活运用 风心病成形 严格把握适应症 不拘泥于成法，不执着于成形 Outcome of 542 cases Mitral Valve Repair Chinese academy of medical sciences FuWai hospital Xu JianPing Preface Advantage of MVP Avoid long time anticoagulation Protect the function of left ventricular Decrease the risk of SBE Lower the risk of embolism and hemolysis postoperatiom Material and method FuWai hospital 1996.10－2008.7 542cases MVP male 359 ；female 183 Age 7Ms-83(42.6)Ys Aetiology Meterial Degree of MI in UCG Preoperation Material UCG preoperation LA LVED EF 49.52±13.50mm 59.21±8.05mm 62.31±10.06 ％ Material NYHA preoperation Surgical Technique CPB －atrial spect incision Damage part of Mitral valve Anterior leaflet 144 cases Posterior leaflet 290 cases both 108 cases Surgical techniques Surgical techniques case cuniform incision 42 cuniform incision ＋annuloplasty 265 cuniform incision ＋ring 59 ring 40 edge to edge 37 edge to edge＋ring 71 chordae transposition 13 chordae shorten 10 additional chordae 6 Surgical techniques CPB time 97.82±37.92 min Aorta clamp time 66.93±32.14 min Intraoperative test infusion water to lv through MV transesophageal echocardiography Surgical techniques TVP CABG AVP AVP CABG TVP (united operation ） vntricular aneurysm ectomy Complications arhythmia 4 cases bleeding 12 cases Circulati