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Effect of coronary artery bypass grafting on moderate ischemic mitral valve regurgitation

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Author:: No author available

Journal Title:: CHINA MEDICINE

Issue:: 7

DOI:: 10.3760/cma.j.issn.1673-4777.2006.07.003

Key Word:: 冠状动脉粥样硬化性心脏病;二尖瓣关闭不全;冠状动脉旁路移植术

Abstract：目的评估行单纯冠状动脉旁路移植术(CABG)的中度缺血性二尖瓣关闭不全(IMR)患者的效果,以探讨最佳治疗方案.方法51例术前诊断为IMR的患者行单纯CABG术.分析术前术后以及随访期二尖瓣关闭不全的程度,左心室功能,左心室内径.结果30 d手术病死率3.9%(2/51),手术后3周内复查超声显示无返流或轻微返流12例,轻度返流21例,中度返流16例.心功能Ⅰ、Ⅱ级者40例,Ⅲ级者9例.左心室内径较术前明显缩小(P＜0.05),左心室功能较术前改善但无明显差异,31例(60.8%)二尖瓣关闭不全程度下降(P＜0.01).随访46例(93.9%),平均24个月.随访期间死亡1例.结论CABG术能降低大部分中度IMR患者的二尖瓣关闭不全程度,但对于并发充血性心力衰竭或左心室功能较低(射血分数＜30%)的中度IMR患者,单纯CABG术可能并不是最佳的治疗方案,应积极处理二尖瓣关闭不全.

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