目的:我们的目的是评估合并成形术在风湿性二尖瓣疾病二尖瓣修复中的疗效。为此,我们总结了这项技术的经验,并分析了术后中期结局.
方法:我们回顾性评估了2011年1月至2018年1月在我们中心接受二尖瓣修复的风湿性瓣膜疾病患者的记录。收集了详细的随访数据。建立了Kaplan-Meier生存曲线,以避免再手术和瓣膜故障。进行多变量Cox回归分析以确定相关终点的预测因子(死亡,再操作,和阀门故障)。
结果:研究期间共有362例患者接受了风湿性二尖瓣修复术。以二尖瓣狭窄为主要病理特征。几乎所有手术都是通过连缝成形术完成的。平均随访时间为25.57±19.91个月。随访期间记录了22(22)个终点事件。术后2年和7年无再手术和瓣膜衰竭生存率分别为93.9%±1.4%和91.5%±2.0%,分别。多因素Cox回归分析显示左心房前后径>60mm(风险比,5.2;p<0.001)是所有终点的独立预测因子。
结论:大多数中国风湿性瓣膜病患者通过连缝成形术联合其他外科手术治疗效果良好,术后中期结局令人满意。
OBJECTIVE: We aimed to evaluate the therapeutic effectiveness of
commissuroplasty in mitral valve repair for rheumatic mitral valve disease. For this purpose, we summarise our experience with this technique and analyse the mid-term postoperative outcomes.
METHODS: We retrospectively evaluated the records of patients with rheumatic valve disease who underwent mitral valve repair between January 2011 and January 2018 at our centre. Detailed follow-up data were collected. A Kaplan-Meier survival curve for survival free from reoperation and valve failure was constructed. Multivariate Cox regression analyses were performed to identify predictors of relevant end points (death, reoperation, and valve failure).
RESULTS: A total of 362 patients underwent rheumatic mitral valve repair during the study period. Mitral valve stenosis was the primary pathological feature. Almost all surgeries were accomplished via
commissuroplasty. The mean duration of follow-up was 25.57 ± 19.91 months. Twenty-two (22) endpoint events were noted during follow-up. The 2- and 7-year rates of survival free from reoperation and valve failure were 93.9%±1.4% and 91.5%±2.0%, respectively. Multivariate Cox regression analysis revealed that left atrial anteroposterior diameter >60 mm (hazard ratio, 5.2; p < 0.001) was an independent predictor of all endpoints.
CONCLUSIONS: Most Chinese patients with rheumatic valve disease were treated effectively via
commissuroplasty combined with other surgical procedures, and the mid-term postoperative outcomes were satisfactory.