west china medical publishers
Keyword
  • Title
  • Author
  • Keyword
  • Abstract
Advance search
Advance search

Search

find Keyword "二尖瓣" 245 results
  • 二尖瓣狭窄下游湍流剪应力与心瓣膜损害的关系

    目的 明确二尖瓣狭窄下游湍流剪应力(turbulent shear stress, TSS)与心瓣膜损害的关系,为在细胞水平研究TSS致心瓣膜内皮损伤提供前期研究. 方法 应用多普勒超声心动图与计算机图像分析技术,以14例正常人为对照(对照组),对1998年1~4月在我院就诊的47例二尖瓣狭窄患者(观察组)心瓣膜病变及其下游TSS进行2年的随访动态观测. 结果 观察组随访期间心瓣膜病变与其下游TSS均呈明显加重趋势(P<0.05),且二者显著相关(r =0.82,0.86);此外,TSS的大小和分布与心瓣膜不同部位病变的严重程度之间存在一定的空间对应关系.结论 二尖瓣狭窄下游所产生的湍流剪应力是构成患者心瓣膜病变进行性加重不容忽视的重要原因,其具体作用机制有待进一步研究加以阐明.

    Release date:2016-08-30 06:34 Export PDF Favorites Scan
  • Mitral Valvuloplasty for the Treatment of Mitral Regurgitation

    Abstract: Compared with mitral valve replacement, there areseveral advantages in mitral valvuloplasty, so recently more and more sights are caught on mitral valve repair. According to different etiology, the surgeon can apply annuloplasty, triangular resection, quadrangular resection, replacement or transposition of chordae tendineae and so on to treat mitral regurgitation(MR). With the development of minimally invasive surgical technology, robotic mitral valve reconstruction evolve rapidly and percutaneous interventional therapy also commence from lab to bedside.We believe surgeons can repair MR safely and successfully in the majority of patients with proficiency in the basic techniques.

    Release date:2016-08-30 06:08 Export PDF Favorites Scan
  • Long-term outcomes following mitral valvuloplasty versus replacement for native valve endocarditis: A case control study

    Objective To compare long-term outcomes following mitral valvuloplasty (MVP) and mitral valve replacement (MVR) for native valve endocarditis (NVE). Methods Between November 1993 and August 2016, consecutive 101 patients with NVE underwent mitral surgery in our department, MVP for 52 patients and MVR for 49 patients. There were 69 males and 32 females at age of 38.1±14.9 years. The mean follow-up was 99.4±75.8 months. Results There was no statistical difference in cardiopulmonary bypass time, aortic cross-clamp time, in-hospital mortality, duration of mechanical ventilation, ICU stay or hospital stay after surgery between the two groups. Survival rate at 1, 5, 10, 20 years after surgery was 100.0%, 97.6%, 97.6%, 97.6% for MVP, and 93.5%, 84.3%, 84.3%, 66.2% for MVR with a statistical difference between the two groups (P=0.018). There was no stroke in the patients with MVP during follow-up periods. However, stroke-free survival rate at 1, 5, 10, 20 years after surgery was 100.0%, 93.9%, 89.4%, 70.2% for MVR patients with a statistical difference between the two groups (P=0.023). There was no statistical difference in recurrence of infection, perivalvular leakage and reoperation between the two groups. Composite endpoint-free survival rate at 1, 5, 10, 20 years after surgery was 100.0%, 97.6%, 92.9%, 92.9% for MVP, and 91.3%, 79.6%, 75.8%, 51.0% for MVR with a statistical difference (P=0.006). Conclusion MVP is associated with better outcomes than MVR in the patients with NVE; generalizing MVP technique in the patients with NVE is needed.

    Release date:2018-03-05 03:32 Export PDF Favorites Scan
  • Lifelong management of mitral stenosis

    Mitral stenosis includes mitral stenosis due to rheumatic fever and non-rheumatic valve stenosis characterized by degenerative changes. Rheumatic mitral stenosis is common in developing countries and occurs in young adults, while degenerative mitral stenosis is common in developed countries and increases in incidence with aging. Mitral stenosis of different etiologies can lead to changes in heart structure and function, which affects the quality of life and prognosis of patients, so lifelong management of mitral stenosis is crucial. This article provides a comprehensive reference for clinicians in the management of mitral stenosis, with a detailed overview of the emerging prevalence features, imaging diagnosis, and treatment methods.

    Release date:2024-10-25 01:48 Export PDF Favorites Scan
  • Efficacy Analysis of Valvuloplasty for Anterior Leaflet Prolapse

    Abstract: Objective To summarize the experiences and analyze the efficacy of mitral valvuloplasty in treating anterior leaflet prolapse. Methods A total of 152 consecutive nonrheumatic heart disease patients including 96 males and 56 females with anterior leaflet prolapse who underwent mitral valvuloplasty from February 1997 to March 2007 were analyzed retrospectively. The age of these patients ranged from 10 to 73 years old (38.54±17.22 years). There were 119 cases of mitral degenerative prolapse or chordae rupture, 24 of ongenital heart disease, 3 of ischemic mitral insufficiency, and 6 of native valve endocarditis. Echocardiography before operation showed the degree of mitral regurgitation was severe in 19, moderate to severe in 63, and moderate in 70 patients. Among the patients, 87 had anterior prolapse and 65 had bilateral prolapse. All patients underwent mitral valve repair under standard cardiopulmonary bypass. Results During the operation, transesophageal echocardiography and saline injection test showed satisfying results in all the patients. No early death occurred after operation. Followup was done to 135 patients for 3 months to 8.5 years with a followup rate of 88.82%. During the follow up, 93 patients were in New Yoke Heart Association(NYHA)class Ⅰ, 35 in Class Ⅱ, 3 in class Ⅲ and 4 in class Ⅳ. The Echocardiography showed that postoperative left atrium diameter (41.09±10.40 mm vs. 45.32±10.07 mm, t=4.186, P=0.000) and left ventricular enddiastolic dimension (52.04±7.74 mm vs. 60.70±7.72 mm,t=9.676, P=0.000) were significantly smaller than that before operation. No or trace mitral regurgitation (MR) was found in 36 patients, mild MR in 45 patients, mild to moderate MR in 38 patients, moderate MR in 9 patients, and moderate to severe MR in 7 patients. Mitral valve replacement was performed in 5 patients after valvuloplasty. Three died during the follow-up. Two of them died of heart failure and one of unknown cause. Conclusion In spite of the complexity, the longterm results of mitral valve repair for anterior leaflet prolapse are satisfactory if the best surgery method is chosen.

    Release date:2016-08-30 06:02 Export PDF Favorites Scan
  • Establishment of mitral regurgitation model by a transapical artificial chordae tendineae implantation device in swines

    ObjectiveTo research the procedure for creating an animal model of mitral regurgitation by implanting a device through the apical artificial chordae tendineae, and to assess the stability and dependability of the device. MethodsTwelve large white swines were employed in the experiments. Through a tiny hole in the apex of the heart, the artificial chordae tendineae of the mitral valve was inserted under the guidance of transcardiac ultrasonography. Before, immediately after, and one and three months after surgery, cardiac ultrasonography signs were noted. Results All models were successfully established. During the operation and the follow-up, no swines died. Immediately after surgery, the mitral valve experienced moderate regurgitation. Compared with preoperation, there was a variable increase in the amount of regurgitation and the values of heart diameters at a 3-month follow-up (P<0.05). ConclusionIn off-pump, the technique of pulling the mitral valve leaflets with chordae tendineae implanted transapically under ultrasound guidance can stably and consistently create an animal model of mitral regurgitation.

    Release date:2024-04-28 03:40 Export PDF Favorites Scan
  • 全胸腔镜体外循环下行二尖瓣瓣膜置换术的围手术期护理

    目的 总结全胸腔镜体外循环下行二尖瓣瓣膜置换的围手术期护理方法与经验。 方法 对2011年7月-2012年4月收治的12例二尖瓣病变拟行瓣膜置换术患者的术前、术后护理措施进行回顾分析,并就术后加强呼吸、循环、引流、疼痛、肢体运动等方面的护理问题进行详细阐述。 结果 12例患者手术顺利,术后7~13 h拔出气管插管,术后21~68 h由重症医学科(ICU)转回病房。11例术后48 h内拔出胸腔闭式引流管,1例82 h拔出引流管。患者均于术后7~12 d痊愈出院。 结论 充分的术前准备及严密的术后观察护理,对预防并发症的发生和患者康复有积极推动作用。

    Release date:2016-09-07 02:34 Export PDF Favorites Scan
  • 国产二尖瓣成形环在心瓣膜成形外科中的应用

    目的 评价国产二尖瓣成形环在心瓣膜成形外科中的疗效.方法 回顾1986年12月~1995年9月在全身麻醉中度低温体外循环下用国产二尖瓣成形环行成形术36例,其中二尖瓣成形28例次,三尖瓣成形9例次.结果 住院死亡4例.术后发生低心排血量综合征5例,呼吸功能不全2例,行气管切开1例,突发心室颤动3例,多器官功能衰竭2例,脑栓塞1例.随访31例无死亡.经超声心动图检查32个成形瓣膜,未见反流5例,轻度反流23例,中度以上反流2例,轻度狭窄2例.跨瓣压差<1.07kPa(8mmHg)24例,1.07~1.73kPa(8~13mmHg)8例.结论 国产二尖瓣成形环在心瓣膜成形外科中具有重要地位.

    Release date:2016-08-30 06:35 Export PDF Favorites Scan
  • 保留二尖瓣装置的二尖瓣置换术

    目的 比较传统二尖瓣置换术 (MVR)和保留二尖瓣装置的 MVR治疗单纯风湿性二尖瓣狭窄的临床效果。 方法 回顾性分析 77例单纯风湿性二尖瓣狭窄行 MVR患者的临床资料 ,按术式不同将其分为 3组 ,组 1:35例 ,保留全部二尖瓣装置 ;组 2 :19例 ,保留二尖瓣后瓣瓣下结构 ;对照组 :2 3例 ,行传统 MVR手术。 结果 术后早期对照组和组 1各死亡 1例 ,晚期对照组死亡 2例 ,组 1和组 2各死亡 1例。术后 3~ 16个月超声心动图检查显示 ,对照组和组 2左心室舒张期末内径 (L VEDD)较术前明显增大 (Plt;0 .0 1) ,组 1L VEDD增大不明显 (Pgt;0 .0 1)。组 1、组 2左心室射血分数 (EF)和短轴缩短率 (FS)较术前有明显改善 (Plt;0 .0 1) ,对照组改善不明显 (Pgt;0 .0 1)。 结论 单纯风湿性二尖瓣狭窄患者行 MVR时保留二尖瓣装置有利于术后左心功能的恢复。

    Release date:2016-08-30 06:28 Export PDF Favorites Scan
  • Comparison between Minimally Invasive Mitral Valve Replacement via Right Minithoracotomy and Traditional Mitral Valve Replacement

    Objective To compare clinical outcomes and safety between minimally invasive mitral valve replacement via right minithoracotomy (mini-MVR) and traditional mitral valve replacement (MVR). Methods Clinical data of 68 patients with valvular heart diseases who underwent mini-MVR from February 2009 to December 2011 in Wuhan Asia Heart Hospital were retrospectively analyzed. There were 36 males and 32 females in this mini-MVR group with their mean age of 34.2±11.2 years. Preoperatively, there were 21 patients with mitral stenosis (MS), 17 patients with mitral insufficiency (MI), 30 patients with MS and MI, and 19 patients with tricuspid insufficiency (TI). Another 200 patients with valvular heart diseases who underwent traditional MVR during the same period were included as the control group. There were 86 males and 114 females in the control group with their mean age of 49.4±13.2 years. Preoperatively, there were 85 patients with MS, 66 patients with MI, 49 patients with MS and MI, and 76 patients with TI. Hospital mortality, aortic crossclamp time, length of intensive care unit (ICU) stay, postoperative chest tube drainage, reexploration for bleeding and postoperative morbidities were compared between the two groups. Results There was no in-hospital death in the mini-MVR group. There was no statistical difference in hospital mortality, cardiopulmonary bypass time, incidence of reexploration for bleeding, postoperative arrhythmias, dialysis-requiring acute renal failure and wound infection between the two group (P>0.05). Aortic crossclamp time of the mini-MVR group was significantly longer than that of the control group. But postoperative mechanical ventilation time (10.2±3.1 h vs. 15.2±7.1 h, P=0.008), chest tube drainage(92.0±28.0 ml vs. 205.0±78.0 ml, P=0.000), blood transfusion (0.8±1.6 U vs. 1.9±2.1 U, P=0.006), length of ICU stay (14.0±8.0 h vs. 26.0±12.0 h, P=0.003) and length of hospital stay (14.8±4.6 d vs. 19.7±3.2 d, P=0.006)of the mini-MVR group were significantly shorter or less than those of the control group. Conclusion The safety of mini-MVR is comparable to that of traditional MVR without causing higher postoperative morbidities, while the postoperative recovery after mini-MVR is better than traditional MVR.

    Release date:2016-08-30 05:45 Export PDF Favorites Scan
25 pages Previous 1 2 3 ... 25 Next

Format

Content