22例保留前瓣叶的二尖瓣膜置换术疗效观察(2)
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在二尖瓣置换手术中保留腱索虽然最终的益处尚不明确，但是有可能改善临床预后已经得到了广泛的认可[1-2]。然而，目前大多数外科医生仅仅保留带腱索的后瓣，主要原因是保留前瓣叶及腱索可能存在潜在的并发症，如：妨碍人工瓣膜机械工作，左室流出道梗塞等[3-4]。为此国内外有学者做了大量的临床研究工作，提出了许多将前叶及腱索缝合在二尖瓣环上的手术方法[4-7]。而本文观察组所采用的手术方法具有安全、可重复以及容易掌握的特点，该观察结果也为二尖瓣置换术中保留前瓣及其腱索提供了广泛的应用前景。
[参考文献]
[1]Yun KI, Sintek CF, Miller DC, et al. Randomized trial comparing partial versus complete chordal-sparing mitral valve replacement:effects on left ventricular volume and function[J]. J Thorac Cardiovasc Surg,2002,123:707-714.
[2]Talwar S, Jayanthkumar HV, Kumar AS. Chordal preservation during mitral valve replacement:basis,techniques and results[J]. Ind J Thorac Cardiovasc Surg,2005,21:45-52.
[3]Thomson LE, Chen X, Greaves SC. Entrapment of mitral chordal apparatus causing early postoperative dysfunction of a St.Jude mitral prosthesis[J].J Am Soc Echocardiogr,2002,15:843-844.
[4]Sasaki H, Ihashi K. Chordal-sparing mitral valve replacement: pitfalls and techniques to prevent complications [J]. Eur J Cardiothorac Surg,2003,24:650-652.
[5]Rafael GF, Lgnacio R, Vanesa E, et al. Posterior transposition of anterior leaflet for complete chordal preservation [J]. European Journal of Cardio-thoracic Surgery,2007,31:550-551.
[6]Chowdhury UK, Kumar AS, Airan B, et al. Mitral valve replacement with and without chordal preservation in a rheumatic population: serial echocardiographic assessment of left ventricular size and function[J].Ann Thorac Surg,2005,79:1926-1933.
[7]Kuralay E, Demirkilic U, Gunay C, et al. Mitral valve replacement with bileaflet preservation: a modified technique [J]. Eur J Cardiothorac Surg,2002,22:630-632.
(收稿日期：2011-05-10)
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