Loop-in-Loop技术在胸腔镜辅助下右胸小切口二尖瓣成形术中的应用

朱喜亮; 程兆云; 王圣; 陈现杰; 陆国庆

doi:10.13201/j.issn.1001-1439.2022.05.013

Loop-in-Loop技术在胸腔镜辅助下右胸小切口二尖瓣成形术中的应用

- 河南省人民医院心血管外科(郑州，450000)
基金项目:
河南省医学科技攻关计划联合共建项目(No：2018020443)；河南省自然科学基金项目(No：202300410405)

详细信息

通讯作者: 王圣，E-mail，wangshengxw@163.com

中图分类号: R541.3

收稿日期: 2021-06-25

刊出日期: 2022-05-13

Results of minimally invasive, thoracoscopic-assisted mitral valve repair with Loop-in-Loop technique

- Department of Cardiovascular Surgery, Henan Provincial People's Hospital, Zhengzhou, 450000, China

More Information

Corresponding author: WANG Sheng, E-mail: wangshengxw@163.com

Received Date: 25 June 2021

Publish Date: 13 May 2022

摘要

摘要: 目的了解Loop-in-Loop技术应用于胸腔镜辅助下右胸小切口二尖瓣成形术中的临床效果。方法回顾并总结我院2018年6月—2020年9月46例单纯二尖瓣反流患者采用Loop-in-Loop技术行胸腔镜辅助下右胸小切口二尖瓣成形术患者的临床资料，分析其术后早期疗效，应用Kaplan-Meier曲线估算总体远期免于中度及以上二尖瓣反流发生率。结果患者均成功手术，无瓣膜置换和中转开胸，围术期未见患者死亡。术后早期并发症包括：因胸壁出血二次开胸止血2例，肺部感染3例，新发心房颤动4例。出院前复查超声提示无或微量二尖瓣反流28例(60.9%)，轻度二尖瓣反流16例(34.8%)，轻-中度二尖瓣反流2例(4.3%)。术后39例(84.8%)患者随访成功，平均随访时间(26.3±15.2)个月，超声提示中度二尖瓣反流2例，重度二尖瓣反流2例(其中1例行二尖瓣置换)。Kaplan-Meier曲线表明，术后12、24和36个月，免于中度以上二尖瓣关闭不全的概率为(96.2±3.5)%、(94.7±3.8)%和(93.4±4.6)%。结论 Loop-in-Loop技术安全有效，可应用于电视胸腔镜辅助下的右胸小切口二尖瓣成形手术。
- 二尖瓣脱垂 /
- 二尖瓣成形 /
- Loop-in-Loop技术 /
- 人工腱索
Abstract: Objective To understand the clinical effect of Loop-in-Loop technique in the application of thoracoscopic-assisted mitral valvuloplasty with Minimally Invasiveincision.Methods We reviewed and summarized the clinical data of 46 patients with simple mitral regurgitation who underwent thoracoscopic-assisted right thoracic small incision mitral valvuloplasty from June 2018 to September 2020 in our hospital using the Loop-in-Loop technology, and analyzed their clinical data. The Kaplan-Meier curve was used to estimate the overall long-term recurrence rate of mitral regurgitation free from more than moderate mitral regurgitation.Results All of the patients were successfully operated without valve replacement and conversion to median thoracotomy. No patient died during the perioperative period. Early postoperative complications included 2 cases of thoracotomy hemostasis for excessive postoperative bleeding, 3 cases of pulmonary infection, and 4 cases of new atrial fibrillation. TTE before discharge revealed no or minimal mitral regurgitation in 28 cases(60.9%), mild mitral regurgitation in 16 cases(34.8%), and mild to moderate mitral regurgitation in 2 cases(4.3%). The 39 patients(84.8%) were followed up successfully in the long-term postoperative period, with an average follow-up time of(26.3±15.2) months. TTE showed 2 cases of moderate mitral regurgitation and 2 cases of severe mitral regurgitation(1 case underwent mitral valve replacement). The Kaplan-Meier curve showed that the probability of avoiding more than moderate mitral regurgitation was(96.2±3.5)%, (94.7±3.8)% and(93.4±4.6)% at 12, 24, and 36 months after surgery.Conclusion Loop-in-Loop technology can be safely and effectively applied to minimally invasive mitral valvuloplasty by thoracoscopic-assisted.
- mitral valve prolapse /
- mitral valvuloplasty /
- Loop-in-Loop technique /
- artificial chordae

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图 1 术中可根据注水试验结果调整第二级Loop长度

Figure 1. Length of the second-level loop can be adjusted according to the water injection test

下载: 全尺寸图片幻灯片

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