戒指和 suture annuloplasty 对于缺血性 mitrale 吐的比较疗效
1Division of Cardiology, Cedars-Sinai Medical Center, Los Angeles, CA 90048.
Circulation
|November 1, 1992
概括
戒指无效整形显著减少缺血额头反 (MR),比接技术更有效. 这种方法为冠状动脉疾病和MR患者提供了更高的成功率.
科学领域:
- 心血管外科心血管外科
- 心脏外科手术 心脏外科手术
- 干预心脏病学 干预心脏病学
背景情况:
- 缺血性心肌反 (MR) 是一个重大的治疗挑战.
- 以前的联合门置换和再血管化结果一直不够理想.
- 门维修是一个有前途的替代方案,但最佳技术需要进一步研究.
研究的目的:
- 为了比较卡蒂尔-爱德华兹环式解剖手术与缺点式解剖手术对缺血性MR的疗效.
- 评估这些技术对残留MR,环形尺寸和患者结局的影响.
主要方法:
- 在60名冠状动脉疾病和严重MR (3+或4+) 的患者中使用了手术内多普勒回声心脏学.
- 患者接受了戒指解剖整形 (n=27) 或 commissural 解剖整形 (n=33).
- 排除标准包括破裂的乳头肌肉,撕裂的胸部和小册子异常.
主要成果:
- 环组显示了显著较低的残留MR等级 (0.5对1.5;p<0.001) 和较大的环形直径缩小 (1.5厘米对0.5厘米;p<0.001).
- 环组的成功率 (≥2级MR减少) 在环组 (96%对67%;p <0.01) 中较高.
- 两组之间的一年生存率相似 (74%对71%),术后的纽约心脏协会功能类别相似.
结论:
- 环结婚术在减少缺血性MR方面更有效,并且与接技术相比,其成功率更高.
- 戒指无环切除术的优异结果可能归因于环形的均缩短和更大的直径缩小.
- 戒指无效整形术代表了一种更有效的手术策略,用于管理缺血性 mitrale 吐.
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