[Valve reconstruction for mitral regurgitation secondary to mitral valve prolapse].

Journal of cardiology. Supplement Pub Date : 1990-01-01
Y Okada, T Shomura, K Yoshida, J Yoshikawa
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Abstract

This study was performed to evaluate the late results of mitral valve replacement for isolated mitral regurgitation and the early results of mitral valve reconstruction for mitral regurgitation secondary to mitral valve prolapse. Between January 1974 and March 1989, 106 patients underwent isolated mitral valve replacement for mitral regurgitation. There were 54 male and 52 female patients ranging in age at operation from 22 to 76 years (average: 50.2 years). Mitral valve replacement with the Carpentier-Edwards bioprosthesis was performed in 55 patients and with the Björk-Shiley disc valve in 51 patients. The follow-up period ranged from four to 182 months with a mean of 64 months. There were three hospital deaths (2.8%). The actuarial survival including hospital deaths were 94.0% at five years and 89.3% at 10 years. The event-free rate was 75.5% at five years and 51.8% at 10 years. There was no significant differences in these results between two prosthetic valve groups. Because of high incidence of prosthetic valve-related events, mitral valve reconstruction for mitral regurgitation was performed in recent two years. Twenty patients had mitral reconstructive surgery. There were 11 male and nine female patients ranging in age at operation from 22 to 70 years (average: 54.4 years). Two had elongated chordae and 18 had torn chordae (anterior leaflet; four cases, posterior leaflet; 14 cases). There was no hospital and late death. One had reoperation because of severe hemolysis.(ABSTRACT TRUNCATED AT 250 WORDS)

二尖瓣脱垂继发二尖瓣返流的瓣膜重建。
本研究旨在评价二尖瓣置换术治疗孤立性二尖瓣反流的晚期效果和二尖瓣重建术治疗二尖瓣脱垂继发二尖瓣反流的早期效果。1974年1月至1989年3月间,106例患者接受了二尖瓣置换术治疗二尖瓣返流。男性54例,女性52例,手术年龄22 ~ 76岁,平均50.2岁。55例患者采用Carpentier-Edwards生物假体进行二尖瓣置换术,51例患者采用Björk-Shiley椎间盘瓣置换术。随访时间4 ~ 182个月,平均64个月。医院死亡3例(2.8%)。包括医院死亡在内的精算生存率5年为94.0%,10年为89.3%。5年无事件率为75.5%,10年为51.8%。两个人工瓣膜组在这些结果上没有显著差异。由于人工瓣膜相关事件的高发生率,近年来二尖瓣重建术用于二尖瓣反流。20例患者行二尖瓣再造术。男11例,女9例,手术年龄22 ~ 70岁,平均54.4岁。2个有延长的脊索,18个有撕裂的脊索(前小叶;后小叶4例;14例)。没有医院和晚期死亡。1例因严重溶血再次手术。(摘要删节250字)
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