首页> 中文期刊> 《安徽医药》 >中重度缺血性二尖瓣反流患者行二尖瓣置换同期冠状动脉旁路移植术的临床研究

中重度缺血性二尖瓣反流患者行二尖瓣置换同期冠状动脉旁路移植术的临床研究

         

摘要

Objective To investigate the impact of combined coronary artery bypass grafting (CABG)and mitral valve replacement (MVR)in patients with moderate-to-severe ischemic mitral regurgitation (IMR).Methods From July 2010 to January 2013,16 pa-tients of coronary artery disease with moderate-to-severe IMR underwent mitral valve replacement combined with coronary artery bypass graft surgery.There were 8 male and 8 female patients,with a mean age of (63.4 ±7.6)years.Preoperative transthoracic echocardio-graphy showed moderate IMR in 2 cases,moderate to severe in 8 cases and severe in 6 cases.The data of preoperative transthoracic ech-ocardiography were compared with postoperative ones.Results Hospital mortality was 6.25%(1 case).Postoperative transthoracic echocardiography showed that there was no regurgitation in 10 cases,minimal in 5 cases,minimal to moderate in 1 case.LVEDD de-creased from (60 ±13)mm to (47 ±12)mm (P <0.05).Conclusions Mitral valve replacement combined with coronary artery by-pass graft is a safe and effective treatment for IMR,the short-term outcomes of which are satisfactory and there is a significant improve-ment of left ventricular function.%目的:探讨二尖瓣置换(mitral valve replacement,MVR)同期冠状动脉旁路移植术(coronary artery bypass grafting,CABG)治疗中重度缺血性二尖瓣反流(ischemic mitral regurgitation,IMR)的效果。方法2010年7月—2013年1月,16例冠状动脉粥样硬化性心脏病(coronary artery disease,CAD)合并中重度 IMR 的患者接受了 CABG 联合 MVR 术。其中男性8例,女性8例;平均年龄(63.4±7.6)岁。术前经胸超声心动图示中度二尖瓣反流2例,中重度8例,重度 6例。比较患者术前及术后经胸超声心动图资料。结果院内死亡1例。术后复查超声心动图示二尖瓣无反流10例,轻度反流5例,轻中度反流1 例。左心室舒张末内径(left ventricular end-diastolic diameter,LVEDD)从(60±13)mm 下降到术后12个月随访时的(47±12)mm(P <0.05)。结论二尖瓣置换同期冠状动脉旁路移植术治疗中重度缺血性二尖瓣反流的近期效果满意,并能明显改善左心室功能。

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