2022 年第 9 期 第 17 卷

二尖瓣成形术的单中心经验与思考

Single center experience and reflection in mitral valvuloplasty

作者：马介旭郭惠明

英文作者：Ma Jiexu Guo Huiming

单位：广东省心血管病研究所广东省人民医院（广东省医学科学院）心脏外科广东省华南结构性心脏病重点实验室，广州510080

英文单位：Department of Cardiac Surgery Guangdong Provincial People′s Hospital Guangdong Academy of Medical Sciences Guangdong Institute of Cardiovascular Diseases Guangdong Province South China Key Laboratory of Structural Heart Disease Guangzhou 510080 China

关键词：风湿性心脏瓣膜病；二尖瓣成形术；瓣膜修复术；二尖瓣关闭不全

英文关键词：Rheumaticheartvalvedisease;Mitralvalvuloplasty;Valverepair;Mitralinsufficiency

• 摘要：

• 二尖瓣疾病是最常见的心脏瓣膜病，目前外科治疗方法仍以二尖瓣置换术为主。尽管二尖瓣成形术（也称瓣膜修复术）可为患者带来更大获益，减少术后心血管不良事件，但更高的技术要求却限制了其普及。广东省心血管病研究所近年来积极开展二尖瓣成形术，胸腔镜下二尖瓣成形术比例已远远超过置换术。发现对二尖瓣病变患者术前进行充分的评估和分级，进行包括瓣环的选择等有针对性的术中处理，可达到良好的瓣膜修复成形术效果。本文简述单中心瓣膜成形术发展历程并就我们在退行性瓣膜病变、风湿性瓣膜病变成形方面开展的工作、研究、实践经验进行总结。希望能为推动二尖瓣成形术的广泛应用提供思路与参考。

• Mitral valve disease is the most common valvular heart disease, and mitral valve replacement is still the main surgical approach at present. Although mitral valvuloplasty (valve repair) can bring greater benefits to patients and reduce postoperative cardiovascular adverse events, higher technical requirements have limited its popularity. In recent years, Guangdong Institute of Cardiovascular Diseases has actively carried out mitral valvuloplasty, and the proportion of mitral valvuloplasty under thoracoscopy has far exceeded that of replacement. It is found that a good effect of valve repair and plasty can be achieved by fully evaluating and grading in patients with mitral valve disease before operation and carrying out targeted intraoperative treatment, including the selection of valve rings. This paper briefly describes the development of single center valvuloplasty and summarizes our work, research and practical experience in the formation of degenerative valve disease and rheumatic valve disease. It is hoped to provide ideas and references for promoting the wide application of mitral valvuloplasty.