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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
  • Mitral Valve Replacement with Modified Anterior Leaflet Preservation Technique

    ObjectiveTo summarize clinical outcomes of mitral valve replacement (MVR) with modified anterior leaflet preservation technique,improve therapeutic effects and reduce postoperative mortality and morbidity. MethodsFrom May 2005 to December 2012,128 patients underwent MVR with modified anterior leaflet preservation technique (modified group) in Beijing Anzhen Hospital,among whom 14 patients received concomitant aortic valve replacement. There were 49 male and 79 female patients in the modified group with their age of 45.0±12.3 years. Another 128 patients who underwent routine MVR during the same period were also included in this study as the control group,including 55 male and 73 female patients with their age of 48.0±8.4 years. There was no statistical difference in preoperative clinical characteristics between the 2 groups (P>0.05). ResultsIn the modified group,there was no perioperative death. Postoperatively,6 patients received reexploration for bleeding,4 patients had low cardiac output syndrome,5 patients had pulmonary infection,1 patient received tracheostomy,and 3 patients had acute kidney failure (AKI). In the control group,5 patients died postoperatively including 3 patients with left ventricular rupture and 2 patients with severe low cardiac output syndrome. Postoperatively,5 patients received reexploration for bleeding,12 patients had low cardiac output syndrome,4 patients had pulmonary infection,and 6 patients had AKI. Echocardiography at 6th month during follow-up showed that left ventricular ejection fraction (LVEF) left ventricular end-diastolic dimension (LVEDD) and left ventricular end-systolic dimension (LVESD) of modified group patients were improved compared with control group patients. There was statistical difference in LVEF and LVESD between the 2 groups (P<0.05). There was no statistical difference in LVEDD between the 2 groups (P>0.05). LVEF,LVEDD and LVESD of modified group patients during follow-up were statistically different from preoperative values (P<0.05). LVEDD of control group patients during follow-up was statistically different from preoperative LVEDD (P<0.05). LVEF and LVESD of control group patients during follow-up was not statistically different from preoperative values (P>0.05). ConclusionMVR with modified anterior leaflet preservation technique is simple to perform with satisfactory short-term results. This technique is suitable for various types of mitral valve diseases especially degenerative mitral valve disease and infective endocarditis.

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  • 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
  • Transapical mitral valve repair with LifeClip system: Early outcome of a single center

    ObjectiveTo evaluate the safety and efficacy of transapical mitral valve repair with moderate-to-severe or severe mitral regurgitation (MR) by using LifeClip system. Methods We retrospectively analyzed the clinical data of 7 symptomatic patients with moderate-to-severe or severe MR who received transapical mitral valve repair by using the LifeClip system in our hospital from July to November 2021. There were 5 males and 2 females with an average age of 76.0±7.5 years. ResultsThere were 2 patients with degenerative MR and 5 patients with functional MR. All of the procedures were successful and 6 patients received 1 LifeClip while the other one patient received 2. The operation time was 135.7±46.9 min, the mechanical ventilation time was 12 (3, 14) h, and the hospital stay time was 18.1±4.1 d. No serious complications or death occurred during the perioperative or follow-up period. MR reduction by ≥2 grades was achieved in all the patients at the one-month follow-up. The classification of cardiac function was improved in varying degrees. Conclusion Transapical mitral valve repair using the LifeClip system shows good safety and efficacy for severe MR patients, and MR degree is significantly improved at early follow-up. However, the benefit of LifeClip should be validated in a larger sample size of Chinese population and through long-term follow-up.

    Release date:2022-05-23 10:52 Export PDF Favorites Scan
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