Clinical Analysis Of Mitral Valvuloplasty In 12 Cases

Objective: By performing a retrospective analysis of patients undergoing mitral valvuloplasty from January 2016 to July 2017 in Department of Cardiovascular Surgery of the Second Hospital of Hebei Medical University,to summarize and evaluate the clinical experience and techniques of the surgery,and to evaluate the short-term and mid-term therapeutic efficacy.To guide the personalized therapy and help to determine the prognosis.Methods:There are 12 patients selected,including 8 males and 4 females,the age of them ranged from 16 to 68 years old.Preoperative grading of mitral regurgitation was performed based on echocardiography,and heart function(NYHA classification)was graded based on the patient's symptoms.All patients were operated mitral valvuloplasty under general anesthesia and hypothermic cardiopulmonary bypass,treat the patients at the same time if combined coronary heart disease,congenital heart disease and other valvular disease.The left ventricular filling test and transesophageal echocardiography(TEE)was used to assess the efficacy of mitral valve forming.Echocardiography was used in postoperative follow-up.Results: There was no perioperative complication and mortality.11 patients were followed-up,the one underwent mitral valve replacement wasn't followed-up,the rate was 91.7%,and the follow –up time range from 6 to 24 months.1 patient had recurrence five months after the surgery,and the postoperative echocardiography showed moderate regurgitation,while others have no recurrence.Postoperative left atrial diameter,end-diastolic diameter and volume of left ventricular,as well as end-systolic diameter and volume of left ventricular were significantly reduced compared with those preoperative.Conclusions:Mitral valvuloplasty combined with artificial annulus,leaflet excisionand artificial fistula can attain good surgical results.It can eliminate or significantly reduce the degree of mitral regurgitation,and reduce the left ventricular preload,so that the internal diameter and volume of the left heart chambers can significantly decline.