僧帽弁閉鎖不全症手術後の左室機能回復の定量的評価 : 術前左室機能別および術式別の比較検討

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We assessed postoperative functional recovery of the left ventricle (LV) in 27 patients with pure mitral regurgitation (MR). The patients were divided into three groups according to the preoperative left ventricular end-systolic volume index (LVESVI) : Group I (LVESVI≧100 ml/m^2) included 7 patients, Group IIR (LVESVI<100 ml/m^2, mitral valve replacement (MVR) was performed) included 10 patients, and Group IIP (LVESVI<100, mitral valve plasty (MVP) was performed) included 10 patients. By means of two-dimensional echocardiography, left ventricular diastolic dimension (LVDd), systolic dimension (LVDs), and fractional shortening (FS) were evaluated before and one month after operation. In Group I, LV function showed a remarkable decrease before and after surgery, and the dilated LV remained over the normal range during the entire study period. In contrast, postoperative functional recovery of the LV was significant in both Group IIR and Group IIP. Postoperative LV function in both groups was equivalent and within the normal range. The above results suggest that operation for MR might be recommendable in patients with a preoperative LVESVI less than 100 ml/m^2. The results also demonstrated that conventional MVR and MVP led to equal function recovery of the LV early after the MR operation.
東京女子医科大学の論文
2000-11-25