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首页> 外文期刊>Circulation journal >Mechanism of and Risk Factors for Reoperation After Mitral Valve Repair for Degenerative Mitral Regurgitation
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Mechanism of and Risk Factors for Reoperation After Mitral Valve Repair for Degenerative Mitral Regurgitation

机译：二尖瓣修复性退行性二尖瓣关闭不全的再手术机理及危险因素

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Background: ?We reviewed our 20-year experience of mitral valve (MV) repair for degenerative mitral regurgitation (MR) and analyzed the mechanisms and risk factors of reoperation. Methods and Results: ?Six hundred and fifty-four patients who underwent MV repair for degenerative MR between 1991 and 2010 were retrospectively reviewed. The mean follow-up duration was 7.5±4.9 years. Late echocardiography was obtained at a fixed schedule. Standard procedures for MV repair were resection and suture for posterior prolapse, artificial chordal reconstruction for anterior prolapse and a combination of them for prolapse of both. Ring annuloplasty was performed in most cases. We encountered 2 early and 23 late reoperations. Fifteen (60%) were valve-related failure, 9 (36%) were procedure-related failure and 1 was unknown. Valve-related failure was characterized with recurrence of MR due to new prolapse region and progression of mitral stenosis due to leaflet thickening. For them, reoperation was performed at 7.6 years and 14.3 years after the initial operation, respectively. Multivariate analysis identified preoperative left ventricular diastolic diameter and residual regurgitation at discharge as risk factors for reoperation. Conclusions: ?Valve-related failure occurred late due to slow progression of degenerative disease. Long-term follow-up after surgery is mandatory. Given that progression and severity of MR were identified as risk factors for reoperation, early surgical intervention is desirable for degenerative MR.??( Circ J ?2013; 77: 2050–2055)
机译：背景：我们回顾了二尖瓣（MV）修复变性二尖瓣关闭不全（MR）的20年经验，并分析了再次手术的机制和危险因素。方法和结果：回顾性分析了1991年至2010年间544例行变性MR MV修复的患者。平均随访时间为7.5±4。9年。晚期超声心动图检查是按固定时间表进行的。 MV修复的标准程序是切除和缝合后路脱垂，人工弦重建以前路脱垂以及将两者结合用于两者脱垂。在大多数情况下，进行环形瓣环成形术。我们遇到了2次早期和23次后期重新手术。 15例（60％）是与瓣膜相关的故障，9例（36％）是与手术相关的故障，其中1例是未知的。瓣膜相关衰竭的特征是由于新的脱垂区域导致MR复发以及由于小叶增厚导致的二尖瓣狭窄进展。对于他们，分别在初次手术后的7.6年和14.3年进行了再次手术。多元分析确定术前左室舒张期直径和出院时残留的反流是再次手术的危险因素。结论：由于退行性疾病进展缓慢，阀门相关的衰竭发生较晚。术后必须长期随访。鉴于MR的进展和严重程度已被确定为再次手术的危险因素，退行性MR的早期手术干预是可取的。（Circ J？2013; 77：2050-2055）

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