The Treatment Of Artificial Chordae Implantation With Appropriate Length In Mitral Valve Replacement For Rheumatic Heart Disease

Objective:To investigate the clinical effect of implanting artificial chordae of appropriate length in patients with rheumatic mitral valve stenosis under mitral valve replacement(MVR).Methods:The clinical data of 105 patients with rheumatic mitral valve stenosis who underwent MVR in the Second Affiliated Hospital of Nanchang University from July 2017 to July 2018 were retrospectively analyzed.Mitral valve replacement was divided according to whether artificial chordae were implanted during the operation.55 cases of artificial chordae implantation group(experimental group)and another 50 cases of mitral valve replacement group(control group).Statistical analysis of the surgical conditions,surgical complications,and early postoperative deaths of the two groups of patients was performed,and changes in cardiac structure and cardiac function before and after surgery were compared between the two groups.Results:The data of the two groups compared the ascending aortic occlusion time,extracorporeal circulation time,and operation time of the experimental group during operation were slightly longer than those of the control group,but there was no statistical difference(P> 0.05).One patient died early in the control group and none died in the experimental group.All patients had no complications such as artificial valve dysfunction,perivalvular leakage,and ventricular rupture.Review the data of the two groups of cardiac color Doppler ultrasound at 5 days,3 months and 1 year.Left ventricular ejection fraction(LVEF),left ventricular end diastolic diameter(LVEDD),left ventricular systole There were significant differences in left ventricular end systolic diameter(LVESD)and cardiac function grading,and the experimental group was significantly better than the control group(P <0.05).Conclusion:Patients with rheumatic heart disease with mitral valve stenosis who implant an artificial tendon of appropriate length in the MVR can effectively establish the continuity between the mitral annulus and the papillary muscle,reconstruct the submitral valve structure and effectively maintain the left ventricular structure It is beneficial to the recovery of left ventricular function after operation and reduces postoperative complications.The long-term follow-up results show that the implantation of artificial chordae is conducive to remodeling the heart structure and improve the quality of life of patients.