二尖瓣成形的技术点(中英文

1、二尖瓣成形的技术要点二尖瓣成形的技术要点joseph f. sabik, m.d.the cleveland clinic手术技术手术技术一个系统工程一个系统工程退行性二尖瓣疾病退行性二尖瓣疾病95% 的瓣膜都是可成形的的瓣膜都是可成形的仅有仅有5或或6种技术种技术三角形切除三角形切除折叠成形折叠成形人工腱索人工腱索 (或腱索转移或腱索转移)交界缝合交界缝合瓣环成形瓣环成形不同部位脱垂不同部位脱垂后叶脱垂后叶脱垂前叶脱垂前叶脱垂双叶脱垂双叶脱垂交界脱垂交界脱垂后叶脱垂成形技术后叶脱垂成形技术长方形切除长方形切除标准成形标准成形 三角形切除三角形切除滑行成形滑行成形 折叠成形折叠成形其它其它双孔

2、法成形双孔法成形人工腱索人工腱索前叶脱垂成形技术前叶脱垂成形技术腱索转移腱索转移人工腱索人工腱索其它其它双孔法双孔法有限切除有限切除交界脱垂成形技术交界脱垂成形技术瓣环成形瓣环成形瓣环成形的指征瓣环成形的指征矫正后瓣环扩大矫正后瓣环扩大增加瓣叶贴合面增加瓣叶贴合面增强版换缝线增强版换缝线预防将来扩张预防将来扩张结果结果病理解剖病理解剖n = 1072生存生存免予再次手术免予再次手术结论结论二尖瓣成形二尖瓣成形95% 瓣膜可成形瓣膜可成形6 种技术种技术生存率生存率免予再次手术率免予再次手术率technical tips & tricks for mitral valve repairj

3、oseph f. sabik, m.d.the cleveland clinicsurgical techniquesa systematic approachdegenerative mitral valve disease95% of valves repairablewith only 5 or 6 techniquestriangular resectionfolding repairartificial chordae (or ch. transfer)commissure closureannuloplastyprolapsing segmentposterior leaflet

4、prolapseanterior leaflet prolapsebileaflet prolapsecommissural prolapseposterior prolapse repair techniquesquadrangular resectionstandard triangular resectionsliding repair folding repairothersedge-to-edge repairartificial chordaeanterior prolapse repair techniqueschordal transferartificial chordaeo

5、thersedge-to-edge repairlimited resectioncommissural prolapse repair techniqueannuloplastyindications for annuloplastycorrect posterior annular dilatationincrease leaflet coaptationreinforce annular suture linesprevent further dilatationresultspathoanatomyn = 1072survivalfreedom from reoperationconcl