Clinical Analysis Of 35 Cases Mitral Valve Plasty

Background:Mitral valve insufficency is the two pieces of mitral valve couldn't be closed in systolic period, because of one or more structure composed of mitral valve change. The pathogenesis of mitral valve insufficency consists of degenerative disease, rheumatoid diease,infectious disease,ischemic disease etc. The surgical therapy style include mitral valve replacement with prostheses valve and mitral valve repair.The patients replacement artificially mechanical disc need lifelong anticoagulation and exists in anticoagulation related complications,anticoagulation excess or deficiency could produce life-threatening serious consequences,it will influence the quality of life seriously, there also consist of valve blocked,the leak of valve circumference,infectious endocarditis and the rupture of left ventricle. Even replacement biological disc, there are also aging problem. Mitral valve plasty have many advantages such as no lifelong anticoagulant therapy, low incidence in thromboembolism and endocarditis, guarantee the postoperative left cardiac and higher long-term surial rates because of it retained normal bicuspid and disc structure under. Mitral valve plasty mainly includes disc ring repair, bicuspid and tendon cable repair and so on many kinds of cases. The indications of mitral valve repair involving the etiology, lesions valve pathological degree, cardiac condition and skills and judgement of who operate the surgery and therefore cannot determine the mode of constant completely.Objective:Study the clinical results and operative methods of mitral valve plasty from analyzed the 35 patients of mitral valve plasty.Methods:Data of 35(29 males and 6 females) patients underwent valvuloplasty from January 2007 to October 2010 in our hospital were retrospectively analyzed.The mean age is 52.2±22.5 years.There were 20 cases of mitral valve prolapse, rheumatic heart disease in 9 cases, coronary heart disease in 4 cases, infective endocarditis in 1 case,1 case of constrictive pericarditis.Twenty four patients were operated with mitral valve repair,and other patients have other cardiac operation with mitral valve repair. Operative technique included mitral annuloplasty only in 9 cases,resection of the leaflet in 11 cases,edge-to-edge technique in 6 cases, posterior commissural placation in 3 cases, artificial chord technique and tendon mobilization in 6 cases. All surgical operation in the cases are placed with annuloplasty ring to control the size of the valve ring, and get the right valve shape and diameter except one with edge-to-edge technique.Results.There were two patients died, the other patients recovered well.Hospital mortality was 5.7%. All patients had a reduction of left atrial diameter and left ventricular end diastolic diameter, but the EF had no change. The period of follow-up was from 3 months to 36 months. Except for 3 patient was lost in follow-up, the heart function of the other patients was improved significantly in 28 patients, there were no insufficiency or only a little with them.Conclusions:Mitral valve plasty should be the first choice for mitral valve insufficiency except patients caused by rheumatism. With proper valvuloplasty technique, selective mitral insufficient patients should achieve satisfying effect. Annuloplasty is effective for repair of mitral valve insufficiency. The edge-to-edge technique is a safe and effective method for treatment of mitral regurgitation with low mortality and morbidity,and excellent early and midterm results.