二尖瓣成形的技術(shù)要點(diǎn)(中英文）ppt課件

1、二尖瓣成形的技術(shù)要點(diǎn)二尖瓣成形的技術(shù)要點(diǎn)Joseph F. Sabik, M.D.The Cleveland Clinic手術(shù)技術(shù)手術(shù)技術(shù)一個(gè)系統(tǒng)工程一個(gè)系統(tǒng)工程退行性二尖瓣疾病退行性二尖瓣疾病95% 的瓣膜都是可成形的僅有5或6種技術(shù)三角形切除折疊成形人工腱索 (或腱索轉(zhuǎn)移)交界縫合瓣環(huán)成形不同部位脫垂不同部位脫垂后葉脫垂后葉脫垂前葉脫垂前葉脫垂雙葉脫垂雙葉脫垂交界脫垂交界脫垂后葉脫垂成形技術(shù)后葉脫垂成形技術(shù)長方形切除規(guī)范成形 三角形切除滑行成形 折疊成形其它雙孔法成形人工腱索前葉脫垂成形技術(shù)前葉脫垂成形技術(shù)腱索轉(zhuǎn)移人工腱索其它雙孔法有限切除交界脫垂成形技術(shù)交界脫垂成形技術(shù)瓣環(huán)成形瓣環(huán)成形瓣

2、環(huán)成形的指征瓣環(huán)成形的指征矯正后瓣環(huán)擴(kuò)展矯正后瓣環(huán)擴(kuò)展添加瓣葉貼合面添加瓣葉貼合面加強(qiáng)版換縫線加強(qiáng)版換縫線預(yù)防未來擴(kuò)張預(yù)防未來擴(kuò)張結(jié)果結(jié)果病了解剖病了解剖N = 1072生存生存免予再次手術(shù)免予再次手術(shù)結(jié)論結(jié)論二尖瓣成形二尖瓣成形95% 瓣膜可成形瓣膜可成形6 種技術(shù)種技術(shù)生存率生存率免予再次手術(shù)率免予再次手術(shù)率Technical Tips & Tricks for Mitral Valve RepairJoseph F. Sabik, M.D.The Cleveland ClinicSurgical TechniquesA Systematic ApproachDegenerativ

3、e Mitral Valve Disease95% of valves repairableWith only 5 or 6 techniquesTriangular resectionFolding repairArtificial chordae (or Ch. Transfer)Commissure closureAnnuloplastyProlapsing SegmentPosterior Leaflet ProlapseAnterior Leaflet ProlapseBileaflet ProlapseCommissural ProlapsePosterior Prolapse R

4、epair TechniquesQuadrangular resectionStandard triangular resectionSliding repair folding repairOthersEdge-to-edge repairArtificial chordaeAnterior Prolapse Repair TechniquesChordal transferArtificial chordaeOthersEdge-to-edge repairLimited resectionCommissural Prolapse Repair TechniqueAnnuloplastyIndications for AnnuloplastyCorrect posterior annular dilatationIncrease leaflet coaptationReinforce annular suture linesPrevent further dilatationResultsPathoanatomyN = 1072SurvivalFreedom from ReoperationConclusion