僧帽弁狭窄症における左室造影所見からみた僧帽弁病変の評価

概要

論文の詳細を見る
Determination of appropriate operative procedure for mitral stenosis (MS), open mitral commissurotomy (OMC) or mitral value replacement (MVR), necessitates the accurate evaluation of the valvular and subvalvular structures of the mitral value. For this purpose cine left ventriculography was reviewed from the standpoint of mitral subvalvular degenerative change and mitral valve pliability in 31 patients who underwent OMC or MVR for MS. The degree of subvalvular fibrosis was quantified as mitral subvalvular distance ratio (DR) from cine left ventriculogram in the right anterior projiection as described by Akins. DR was obtained by calculating the ratio of the maximum length of hte chordae tencineae to the long axis of the left ventricle in diastole as indicated by Fig.1. The mitral valve pliability was evaluated by the mitral valve pliability ratio(PR) obtained by calculatiing the ratio of the width of mitral mobility to the long axis diameter of mitral leaflet utilizing the standard cine left ventriculogram in the lateral projection as indicaited by Fig.2. The combination of DR and PR was found to be very useful inpredicting the degree of mitral degenerative change preperatively and indicated objectively the appropriate operative procedure for MS, OMC of MVR. The patients with DR<0.140 or PR<0.40 are thought to be good candidates for MVR. DR≧0.140 and PR≧0.40 would guarantee good result of OMC.
神戸大学の論文