前弦切割不仅损害了区域左心室功能,而且在腹回中也损害了区域右心室功能
T Le Tourneau1, D Grandmougin, C Foucher
1Service d'Explorations Fonctionnelles Cardio-vasculaires, Services de Chirurgie Cardio-vasculaire, Hôpital Cardiologique, Lille, France.
Circulation
|September 25, 2001
概括
在为 mitra 排泄而进行 mitra 置换期间的前弦切割会损害左心室和右心室的功能. 这种外科手术方法对区域心室性能产生负面影响,突出显示了对心脏健康的潜在风险.
科学领域:
- 心血管外科心血管外科
- 评估心脏功能的评估
- 中心门疾病的疾病.
背景情况:
- 通过 chordae tendineae 维护无心室连续性对于维持左心室 (LV) 功能和改善术后结果至关重要.
- 副心脏反 (MR) 需要考虑对整体心脏功能的影响的干预措施.
研究的目的:
- 预期评估前弦切割对MR患者全球和区域LV和右心室 (RV) 功能的影响.
- 为了比较关 (MV) 修复与MV替换与前弦切割的功能结果.
主要方法:
- 65名患有严重MR的患者接受了手术前和后的放射性核素血管造影.
- 患者被分为MV修复 (42) 或MV替换与前弦切断 (23) 组.
- 对两个心室的全球和区域喷射分数 (EF) 进行了分析,评估每个心室的9个区域.
主要成果:
- 用前弦切割替换中枢导致LV喷射率 (LVEF) 显著下降,而RV喷射率 (RVEF) 没有变化.
- 中心的修复没有显著改变LVEF,但改善了RVEF.
- 区域分析显示,在前侧 papillary 肌肉插入区域的LVEF受损,在 MV 替换与弦切割后,在 apicoseptal 区域的 RV 功能受损.
结论:
- 在MV替换MR期间的前弦切断会对区域LV功能产生不利影响.
- 这种手术技术还导致区域RV功能显著受损.
- 这些发现表明,保持带完整性对于在米特拉手术后保持最佳心室性能至关重要.
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