带状切割的有效性,以缓解慢性持续性缺血性 mitrale 吐
Emmanuel Messas1, Bruno Pouzet, Bernard Touchot
1Faculté de Médecine Necker-Enfants Malades, INSERM EMI-0016, Ecole de Chirurgie, Assistance Publique - Hôpitaux de Paris, Service de Cardiologie 1 et de Chirurgie Cardio -Vasculaire, Hôpital Européen Georges Pompidou, Paris, France.
Circulation
|September 13, 2003
概括
切断特定的心脏带有效地治疗慢性缺血额头吐,没有负面影响. 这种微创手术改善了心脏功能,并减少了心脏缺血性心脏病患者的腹.
科学领域:
- 心血管外科心血管外科
- 心脏机械学 心脏机械学
- 心脏门疾病 心脏门疾病
背景情况:
- 副心脏反 (MR) 是缺血性心脏病的常见并发症,由于传单绑定,通常不够用标准方法治疗.
- 带与排位的乳头肌肉的结合限制了叶片的关闭,导致尽管左心室 (LV) 改造,但仍然存在着 MR.
- 之前的急性病例模型显示,切割带以减少MR是有前途的,但在经过高级重塑的慢性病症中疗效尚不清楚.
研究的目的:
- 在羊模型中评估切割特定的基底虫在减少慢性持续性缺血性 mitrale 吐 (MR) 的有效性.
- 评估这项干预措施对左心室 (LV) 功能,门几何学以及落或复发MR的发生率的影响.
- 为了确定长期的安全性和有效性,在慢性缺血性MR中切割带.
主要方法:
- 七只患有慢性基底下心脏病发作和进展性MR的羊在小册子底部切断了两个中心基底.
- 使用三维回声心脏图来量化MR严重程度,LV功能 (射出分数) 和门几何在手术前后.
- 五只额外的绵羊被长期跟踪后底心脏病发作和弦切割,以评估持续的影响.
主要成果:
- 切割中央基底显著降低了所有7只羊的MR,使其恢复到基线水平 (吐分数显著下降,P<0.0001).
- 该程序有效地改善了小册子的合,但没有导致门脱落或LV射出分数 (EF) 的下降 (41.1%至42.6%,P=NS).
- 在5只绵羊的长期随访中,没有出现缩或复发性MR的证据,心脏病发作后的LVEF也没有显著下降.
结论:
- 切割几种基底的微创方法通过改善叶片合并来有效地减少慢性持续性缺血性MR.
- 这种技术为缺血性MR提供了一个有前途的治疗选择,而不会损害LV喷射分数或引起门不良事件.
- 冠状动脉切割是长期安全和有效的,即使在由于心脏病发作而导致显著的LV重塑后进行.
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