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目的 评价Carpentier-Edwards physioⅡ和SJMTM刚性鞍形成形环在退行性二尖瓣关闭不全二尖瓣成形术中的应用效果.方法 2011年1月至2014年9月间,应用二尖瓣成形术治疗退行性二尖瓣关闭不全患者100例,排除成形失败者,入选97例,将应用Carpentier-Edwards physioⅡ(C-E组)置入的48例,与同期采用SJMTM刚性鞍形成形环(SJMTM组)的49例临床资料匹配患者比较术后疗效.结果 围术期两组均无死亡.两组手术方法、瓣环大小、主动脉阻断时间、体外循环辅助时间、住院时间和住ICU时间差异均无统计学意义.术后均获随访3个月～3年.心功能、二尖瓣反流均明显改善.随访期超声心动图显示两组术后左心房内径、左心室舒张末内径、左心室收缩末内径、反流束面积/左心房面积、肺动脉收缩压均明显降低(P＜0.01),射血分数明显增加(P＜0.01),心输出量明显增加(C-E组P＜ 0.01,SJMTM组P ＜0.05),两组间比较差异无统计学意义.两组术后跨瓣压差均＜3 mmHg(1 mmHg =0.133 kPa).结论 Carpentier-Edwards physioⅡ和SjMTM刚性鞍形成形环应用于退行性二尖瓣关闭不全成形术的近期疗效满意.

Objective To evaluate the outcomes of application of Carpentier-Edwards Physio Ⅱ and SJM TM rigid saddle ring in mitral valve repair for degenerative mitral regurgitation.Methods From January 2011 to September 2014, 48 cases underwent mitral valve repair using Carpentier-Edwards Physio Ⅱ1 (C-E group), and 49 cases used SJMTM rigid saddle ring (SJMTM group), the outcomes were compared between the two groups.Results No early death occurred in both groups after operation.The methods of operation, the size of ring, aortic clump time, CPB time, hospital stay time and ICU stay time had not significant statistical difference.All patients were followed up for 3 months to 3 years, and the cardiac function, mitral valve regurgitation were significantly improved.The echocardiography showed that postoperative left atrium diameter, left ventricular end-diastolic dimension, left ventricular end-systolic dimension, and the ratio of regurgitation beam area and left atrial area, pulmonary artery systolic pressure were significantly smaller than that before operation(P ＜ 0.01).Ejection fraction(EF)increased greatly(P ＜ 0.01), and cardiac output increased greatly(P ＜0.01 in C-E group, P ＜ 0.05 in SJMTM group).However, there were no statistical differences between the two groups.Postoperative mean mitral gradient was less than 3 mmHg.Conclusion Application of Carpentier-Edwards Physio Ⅱ and SJMTM rigid saddle ring in mitral valve repair is safe and effective for treating degenerative mitral regurgitation with excellent early outcomes.