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find Author "HAN Jingsong" 1 results
  • Mitral Valve Repair with Artificial Chordae in 78 Patients with Mitral Valve Prolapse

    Objective To analyze early and midterm outcomes and summarize clinical experience of mitral valve repair with artificial chordae for degenerative mitral regurgitation (MR). Methods Clinical data of 78 patients with degenerative MR who underwent mitral valve repair with Gore-Tex artificial chordae from October 2008 to December 2011 in General Hospita1 of Shenyang Military Command were retrospectively analyzed. There were 47 male patients and 31female patients with their age of 52.7±9.6 years,who all had degenerative MR. Operation techniques included simple GoreTex artificial chordae replacement in 15 patients,artificial chordae replacement plus quadrangular resection of the posterior leaflet in 58 patients,artificial chordae replacement plus quadrangular resection of the posterior leaflet and Sliding technique in 5 patients. One to three (2.15±1.05) Gore-Tex artificial chordae were used for each patient,and annuloplasty ring was used for all the patients. Thirty-nine patients underwent concomitant tricuspid valvuloplasty. Intraoperative transesophagealechocardiography showed none obvious MR in 62 patients,trivial MR in 13 patients and mild MR in 3 patients. All thepatients were followed up after discharge. Echocardiography was used to evaluate heart function and MR degree duringfollow-up. Results There was no in-hospital death in this group. Postoperative complications included sinus bradycardiain 5 patients,supraventricular tachycardia in 8 patients,late cardiac tamponade in 1 patient,and permanent pacemakerimplantation in 1 patient. Seventy patients were followed up for 1-2 years with the follow-up rate of 89.74% (70/78). Duringfollow-up,1 patient died of cerebral embolism 13 months after discharge,and all the other patients remained alive. There were 60 patients with NYHA classⅠand 9 patients with NYHA classⅡ. Echocardiography at 1 year after dischargeshowed that left atrial diameter,left ventricular end-diastolic diameter,left ventricular end-systolic diameter,and pulmonary artery systolic pressure were significantly smaller or lower than preoperative values (P<0.05),left ventricular ejection fraction (68.00%±7.00% vs. 55.00%±6.00%) and cardiac output were significantly higher than preoperative values(P<0.05),and MR degree (ratio of regurgitation beam area and left atrial area) was significantly reduced compared with preoperative MR degree (3.45%±5.56% vs. 39.55%±9.86%,P<0.05). No artificial chordae rupture was found. There were47 patients without MR and 22 patients with trivial MR during follow-up. Conclusion Gore-Tex artificial chordae replacement is a safe and effective surgical technique for the treatment of degenerative MR.

    Release date:2016-08-30 05:47 Export PDF Favorites Scan
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