刘先宝,蒲朝霞,余蕾,冯燕,何伟,林剑靖,胡泼,王建安,葛均波

• 1:浙江大学医学院附属第二医院心脏中心
• 2:上海复旦大学附属中山医院心内科

摘要(Abstract)：

目的评估经导管二尖瓣夹合术(MitraClip)治疗中重度或重度二尖瓣反流患者的安全性和有效性。方法 2013年10月至2014年3月,使用MitraClip系统对10例有症状的中重度(1例)或重度(9例)二尖瓣反流患者行经导管二尖瓣修复术,分析10例患者手术即刻效果和30 d随访结果。结果 10例患者的平均年龄(74±10.6)岁,功能性反流8例,器质性反流2例。所有手术均成功开展,顺利置入1个(5例)或2个(5例)MitraClip。手术即刻效果提示,5例患者二尖瓣反流下降3级,5例患者下降2级,未发生相关并发症。30 d超声心动图随访提示,所有患者二尖瓣反流较术前降低≥2级,左心室射血分数(LVEF)由(40.2±11.9)%提高到(44.8±11.6)%,左心房内径和舒张期左心室内径分别由(6.4±0.5)cm和(6.1±0.8)cm缩小至(6.0±0.5)cm和(6.0±0.8)cm。所有患者的主观症状较术前有不同程度的改善,纽约心功能分级均较术前提高1级,生活质量评分和6 min步行试验分别由(0.7±0.2)和(279.0±123.0)m提高到(0.9±0.1)和(347.0±91.0)m。结论本中心初步经验提示,经导管二尖瓣夹合术(MitraClip)可以带来超声心动图指标的改善和早期的临床获益,是安全有效的,但中远期效果有待于进一步随访。

关键词(KeyWords)： 二尖瓣反流;经导管瓣膜修复术;经导管二尖瓣夹合术

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 刘先宝,蒲朝霞,余蕾,冯燕,何伟,林剑靖,胡泼,王建安,葛均波

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