COMPARATIVE STUDY BETWEEN VALVE REPAIR AND REPLACEMENT FOR MITRAL PURE REGURGITATION : Early and Late Postoperative Results
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概要
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From May 1975 through December 1988, 91 patients (mean age 50.4±12.8 years) had first-time surgery for mitral pure regurgitation; 48 had mitral valve replacement (MVR) and 43 had valve repair. A majority of the patients had non-rheumatic valvular diseases. Those patients who underwent repair had less hemodyanamic and functional derangement than those who underwent MVR. The operative mortality was 8.3% in the MVR group and 2.3% in the repair group. Seventeen percent of the MVR group and 2% of the repair group required intra-aortic balloon pumping support (p<0.03). A higher dose of dopamine and/or dobutamine during the early postoperative period was necessary in the MVR group (7.0±4.8μg/kg/min) than in the repair group (5.1±3.1μg/kg/min). Duration of respirator support for hospital survivors was longer in the MVR group (2.3±2.7 days) than in the repair group (1.4±1.0 days). There were 5 late deaths (2.2±1.0%/pt-yr) not counting 6 non-cardiac deaths in the MVR group and 1 (0.6±0.6%/pt-yr) in the repair group. There were 17 patients (7.5±1.8%/pt-yr) who experienced ,treatment failure in the MVR group and 5 (2.3±1.3%/pt-yr) in the repair group (p<0.02). Eight patients in the MVR group (3.5±1.3%/pt-yr) underwent repeat surgery in the late postoperative period, as did 3 (1.7±1.0%/pt-yr) in the repair group. There was no increase in the incidence of repeat surgery after valve repair. All the current survivors in the repair group, and 96% of those in the MVR group were in NYHA functional class I or II. These results indicate that mitral repair is the preferred operative procedure for pure mitral regurgitation, whenever it is possible.
- 社団法人日本循環器学会の論文
- 1991-05-20
著者
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Tominaga Ryuji
Department Of Cardiovascular Surgery Faculty Of Medicine Kyushu University
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Tominaga Ryuji
九州大学 医学部循環器外科学分野
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Kawachi Yoshito
The Department Of Cardiovascular Surgery Faculty Of Medicine Kyushu University
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TOMINAGA Ryuji
Division of Cardiovascular Surgery, Faculty of Medicine, Kyushu University
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TOKUNAGA Kouichi
Division of Cardiovascular Surgery,Research Institute of Angiocardiology Kyushy University
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KAWACHI YOSHITO
Division of Cardiovascular Surery, Faculty of Medicine Kyushu University
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OE MASAHIRO
Division of Cardiovascular Surgery, Faculty of Medicine, Kyushu University
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ASOU TOSHIHIDE
Division of Cardiovascular Surgery, Faculty of Medicine, Kyushu University
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Tokunaga Kouichi
Division Of Cardiovascular Surgery Faculty Of Medicine Kyushu University
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Tokunaga Kouichi
Department Of Cardiovascular Surgery And Clinical Research Laboratory National Kyushu Medical Center
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Oe Masahiro
Division Of Cardiovascular Surgery Faculty Of Medicine Kyushu University
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Asou Toshihide
Division Of Cardiovascular Surgery Faculty Of Medicine Kyushu University
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Tominaga Ryuji
Department Of Cardiovascular Surgery Kyushu University Hospital
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Tominaga Ryuji
Division Of Cardiovascular Surgery Research Institute Of Angiocardiology Faculty Of Medicine Kyushu
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Tokunaga Kouichi
Division Of Cardiovascular Surgery Cardiovascular Clinic Kyushu University
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Tominaga Ryuji
Department Of Cardiovascular Surgery Kyushu University School Of Medicine
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Tokunaga Kouichi
Department Of Cardiovascular Surgery Research Institute Of Angiocardiology Kyushu University Faculty
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Tokunaga Kouichi
Department Of Cardiovascular Surgery And Cardiovascular Clinic
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Kohda Yoshio
Division Of Cardiovascular Surgery Research Institute Of Angiocardiology Faculty Of Medicine Kyushu
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Tokunaga Kouichi
Division Of Cardiovascular Surery Faculty Of Medicine Kyushu University
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Tokunaga Kouichi
Department Of Cardiovascular Surgery And Clinical Research Laboratory National Kyushu Medical Center
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