首页|"衬裙"技术在二尖瓣再次手术中应用的单中心回顾性研究

"衬裙"技术在二尖瓣再次手术中应用的单中心回顾性研究

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目的 探讨及评估"衬裙"技术在二尖瓣再次手术中的安全性和有效性.方法 回顾性分析2019-2021年于武汉亚洲心脏病医院行"衬裙"手术的二尖瓣再次手术患者的临床资料.结果 纳入26例患者,其中男7例、女19例,年龄27~67(53.46±11.18)岁.23例患者曾行二尖瓣置换术,3例患者曾行二尖瓣修复术;再次手术均采用"衬裙"技术置换理想大小的二尖瓣人工瓣膜,其中1例因神经系统并发症死亡.体外循环时间和主动脉阻断时间分别为(231.11±77.05)min和(148.50±52.70)min;再次置换机械瓣22例,置换生物瓣4例,植入的人工二尖瓣平均直径为(29.08±0.68)mm,相较于置换前瓣膜尺寸[(26.69±0.77)mm]明显增大,差异有统计学意义(P<0.001);术后超声心动图检查人工二尖瓣的平均跨瓣压差为(14.77±5.34)mm Hg,相较于术前[(20.92±9.83)mm Hg]明显降低,差异有统计学意义(P=0.005).结论 "衬裙"技术应用于二尖瓣环较小的再次手术患者安全、有效,不仅可以降低再次手术的风险,还可以获得较大尺寸的人工瓣膜植入,进而获得良好的血流动力学特征和临床效果.
Application of Chimney technique in mitral valve reoperation:A retrospective study in a single center
Objective To investigate and evaluate the safety and effectiveness of the Chimney technique in mitral valve reoperation.Methods The clinical data of mitral valve reoperation patients who underwent Chimney surgery in Wuhan Asia Heart Hospital from 2019 to 2021 were retrospectively analyzed.Results A total of 26 patients were collected,including 7 males and 19 females,aged 27-67(53.46±11.18)years.All patients had previous mitral valve surgery,including 23 mitral valve replacements and 3 mitral valve repairs.All patients received Chimney technique using the ideal artificial sized mitral valve,and 1 patient died of neurological complications in hospital.The cardiopulmonary bypass time and the aortic cross-clamping time were 231.11±77.05 min and 148.50±52.70 min,respectively.The mean diameter of the implanted mitral valve prosthesis was 29.08±0.68 mm,which was statistically different from pre-replacement valve prosthesis size of 26.69±0.77 mm(P<0.001).The mean transvalvular pressure gradient of the prosthetic mitral valve measured on postoperative echocardiography was 14.77±5.34 mm Hg,which was statistically different from preoperative value of 20.92±9.83 mm Hg(P=0.005).Conclusion The Chimney technique is safe and effective for reoperation in patients with small mitral annuli,which can not only reduce the risk of reoperation,but also obtain larger prosthetic valve implants with good hemodynamic characteristics and clinical outcomes.

Heart valve diseaseprosthesis-patient mismatchreoperationmitral valve replacementChimney technique

刘文豪、宋来春、杨明远、吴竞成、陶凉

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武汉大学附属武汉亚洲心脏病医院心脏大血管外科(武汉 430000)

心脏瓣膜病 人工瓣膜-患者不匹配 再次手术 二尖瓣置换术 "衬裙"技术

2024

中国胸心血管外科临床杂志
四川大学华西医院

中国胸心血管外科临床杂志

CSTPCD北大核心
影响因子:0.846
ISSN:1007-4848
年,卷(期):2024.31(5)
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