ALL THE NEW IS THE WELL FORGOTTEN OLD: AUTOPERICARDIAL MITRAL ANNULOPLASTY FOR DEGENERATIVE DEFECTS

S. A. Zhurko, A. Gamzaev, K. M. Aminov, P. V. Pimenova
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Abstract

Objective: To present the first-hand results of a modified mitral annuloplasty (MA) with an autopericardial strip (APS) in degenerative mitral valve disease (DMVD). Methods: Fifty-three patients with DMVD (mean age, 54.9±9.5 years (36-78 years); n=32 men (60.4%) and n=21women (39.6%)) undergoing MA with an APS, between January 2017 and January 2020 were retrospectively studied. In the overwhelming majority of cases, triangular and quadrangular resections of the P2 segment were performed. In addition, in some cases, neochords were implanted to the A2 segment. Intraoperatively, the result of MA was considered satisfactory if, according to transoesophageal echocardiography, the degree of mitral regurgitation (MR) did not exceed grade 1. Results: No in-hospital mortality was observed. One female patient had an early relapse caused by the rupture of one of the neochords at the A2 segment. However, the MR did not exceed grade 2, and the patient was actively followed up. Conclusion: Individual APS length selection avoids overcorrecting and achieves adequate systolic and diastolic mitral valve performance. Keywords: Annuloplasty, mitral regurgitation, autopericardium, mitral regurgitation.
所有新的都是被遗忘的旧的:自体心包二尖瓣成形术治疗退行性缺陷
目的:介绍改良二尖瓣环成形术(MA)与自心包带(APS)治疗退行性二尖瓣疾病(DMVD)的第一手结果。方法:53例DMVD患者(平均年龄54.9±9.5岁,36-78岁);回顾性研究了2017年1月至2020年1月期间接受MA合并APS的男性32名(60.4%)和女性21名(39.6%)。在绝大多数情况下,对P2节段进行三角形和四边形切除。此外,在一些病例中,新声带被植入到A2段。术中,如果经食管超声心动图显示二尖瓣反流(MR)不超过1级,则认为MA的结果令人满意。结果:无院内死亡。1例女性患者因A2段新声带破裂而早期复发。然而,MR未超过2级,并积极随访患者。结论:个体化的APS长度选择避免了矫治过度,达到了适当的收缩和舒张二尖瓣性能。关键词:环成形术,二尖瓣反流,心包自闭,二尖瓣反流。
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