The Application Of Mitral Valve Repair Mitral Regurgitation In Adult Patients

ObjectiveIndoor part blood reflux left heart left atrium called the Mitral Regurgitation(MR), can cause the left cardiac insufficiency,if not treated,serious consequences.This project aims to summarize clinical experience and evaluate early and midterm of mitral valve rapair in adult mitral regurgitation.To explore surgical treatment of mitral valve regurgitation and prognosis of forming and the related clinical features.MethodsThe in-patient date and follow-up outcomes of 56 patients after mitral valve repair of mitral regugitation from December 2010 to June 2012 were analyzed retrospectively.The male 34 cases, female 22 cases, aged from42 to69 years old, an average of 54.51 cases degenerative diseases, infectious disease 3 cases, ischemic lesions in 2 cases, all patients have different degree of preoperative symptoms such as chest tightness, shortness of breath, palpitation, cardiac function (NYHA classification) Ⅱ level 3 cases, Ⅲ 46 cases, IV level 7 cases. Preoperative echocardiography in 18 cases of severe reflux, severe reflux 38 cases, merge above moderate tricuspid regurgitation in 21 cases, coronary atherosclerotic heart disease 3 cases.All patients were treated with surgical treatment bypass (CPB), anesthesia, superior and inferior vena cava cannulas were inserted respectively or single-tube inserted in right atrial appendage, then established CPB. Anesthesia after a successful check, transesophageal echocardiography (TEE) clear mitral valve prolapse, chordae tendineae and degree of reflux.56 patients were performed chest midline incision, the ascending aorta for blood vessels, the inferior vena cava intubation respectively on drainage and block, the right atrium interatrial septum incision, probe the mitral valve, the disc lobe resection, chordae tendineae repair, transfer, the Core-Tex artificial chordae tendineae placement, edge to edge and artificial disc ring placement. The same line of tricuspid valve forming 21 cases,3 cases of coronary artery bypass grafts, radiofrequency ablation in 2 cases. Intraoperative observation of valvular regurgitation in water injection parts, valve involution, formed water injection again observe valve opening and closing, evaluate mitral valve opening and closing of transesophageal echocardiography (TEE) and valve function. Art congealed in esophageal echocardiography tip no obvious reflux 48 cases, mitral valve trace reflux 6 cases, mild reflux in 2 cases, all patients had no mitral valve stenosis.Using SPSS 16.0 statistical software for statistical processing. Data with mean standard deviation (s) said, measurement data using paired t test, counting data using X2 test, P<0.05, the difference was statistically significant.ResultsThere was no in-hospital death in this group.When discharged from hospital,there were significantly improvements in cardial function.52 patients were followed up with a follow-up rate of 92.9%(52/56) for18-36 months. One year after discharge echocardiography showed distinct reduction in left atrial diameter,left ventricular end-diastolic diameter,left ventricular end-systolic diameter,and distinct increase left ventrcular ejection fraction compared with preoperative statistics.ConclusionsAdult mitral regurgitation in use of mitral valve repair can achieve effective clinical results and can enhance heart function.