欢迎访问《现代生物医学进展》编辑部！

目的：探讨外科手术治疗成人动脉导管未闭（PDA）合并重度二尖瓣返流（MR）的疗效。方法：回顾性分析2009 年1 月至 2011 年1 月在本中心实施外科手术治疗6 例PDA 合并MR 患者的临床资料。5 例实施PDA 缝扎术和二尖瓣置换术，1 例实施 PDA 缝扎术和二尖瓣成形术。分别于术前、术后1 周、1 月、3 月和1 年行超声心动图检查，观察并测定左室舒张末期内径（LVEDD）和左室射血分数（LVEF）等指标的变化。结果：6 例术后PDA 均无残余分流。心脏彩超检查显示, 术后1 周与术前相比， LVEDD 显著缩小(P< 0.01)，术后1 个月较术后1 周进一步缩小(P< 0.01)，术后3 个月与术后1 个月比较以及术后1 年和术后3 月比较LVEDD 有所减少，但差异无统计学意义。LVEF 术后比术前有所降低，但差异无统计学意义。所有病例在术后随访中未出现栓塞和出血等并发症。结论：外科手术治疗PDA 合并MR 疗效满意。术前单纯重度MR 患者易漏诊PDA，应尽可能明确诊断。

英文摘要:

Objective: To evaluate the therapeutic effect of surgical operation for patent ductus arteriosus ( PDA) combined with severe mitral regurgitation (MR). Methods: From Jan 2009 to Jan 2011, the clinical data of 6 cases suffered from PDA combined with severe MR performed surgical operation were analyzed retrospectively. All cases were performed surgical repair of PDA with sutures under cardiopulmonary bypass and 5 cases undrwent mitral valve replacement and 1 case underwent mitral annuloplasty simultaneously. Parameters including left ventricular end-diastolic diameter (LVEDD) and left ventricular ejection fractionn (LVEF) were observed by echocardiography in preoperation and postoperation of 1 week, 1 month, 3 months and 1 year respectively. Results: There were no residual shunt and no serious complications including hemorrhage and embolism after the operation in follow-up. The LVEDD significantly decreased in postoperation of 1 week compared with preoperation (P<0.01) and it further decreased in postoperation of 1 month compared with that of 1 week (P<0.01). The LVEDD decreased continously in postoperation of 3 months and 1 year, but there was no statistical significant difference between them. Despite the LVEF of postoperation was lower than that of preoperation, there was no statistical significant difference between them. Conclusions: The surgical operation for PDA combined with severe MR is safe and effective. PDA was fallibly neglected in patients diagnosed simplex severe MR before operation, therefore, the realizing diagnosis in preoperation is necessary and beneficial.

View Full Text View/Add Comment Download reader