Strategies for surgical treatment of ischemic mitral incompetence
10.3760/cma.j.issn.0529-5815.2017.01.014
- VernacularTitle: 缺血性二尖瓣关闭不全的外科治疗策略
- Author:
Zhibing QIU
1
;
Xin CHEN
Author Information
1. Department of Cardiovascular Surgery, Nanjing Hospital Affiliated to Nanjing Medical University, Nanjing First Hospital, Nanjing 210006, China
- Publication Type:Journal Article
- Keywords:
Mitral valve insufficiency;
Myocardial ischemia;
Cardiovascular surgical procedures
- From:
Chinese Journal of Surgery
2017;55(1):54-58
- CountryChina
- Language:Chinese
-
Abstract:
Treatment of ischemic mitral incompetence (IMI) is an important problem in cardiovascular surgery, and it is arguing to the best strategies for surgical treatment of IMI. IMI can be quantitative assessment precisely by three-dimensional ultrasonic sound. Perioperative transesophageal echocardiography can acquire detailed information about IMI, but it is possible to underestimate the degree of IMI. The effective mitral regurgitation area at resting are the independently prognosis factor in patients with IMI. So it is necessary to sufficiently evaluate the patients before operation in order to predict the operative effect and risk. It is the choice for the best strategies for surgical treatment of IMI regarding to patients symptom, the degree of IMI, cardiac reconstruction. The therapy strategies should be weighed the operative risk and long-term benefit for moderate IMI, so that combining CABG with concomitant mitral surgery or not would be decided. It is arguing to mitral valve replacement or repair for surgical treatment of severe IMI. The surgical methods should be chosen carefully according to left ventricular remodeling and pathological changes of mitral valve. The effect of mitral valve repair is dependent on correctly perform. The suitable repair technique and plasty ring should be selected actively.
