狭窄を主とする僧帽弁疾患に対する自己弁温存手術の妥当性 ―心カテーテル法と心エコー図検査による証明―
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概要
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From 1954 to 1979, a period of 25 years, a total of 778 cases of mitral valve surgery were conducted at the Sapporo Medical College by the Department of Surgery (Thoracic and Cardiovascular Surgery Department) and the results were analyzed. In this series, 65 per cent of the cases were done on mitral stenosis. The purpose of this communication is to demonstrate the validity of preservation of diseased mitral valve instead of replacement at the time of surgery. The long-term results of this series showed that the survival rate for commissurotomy was found to be much more superior (92.5%) to that of replacement (59.4%). Extensive preoperative echocardiographic assessment for mitral stenosis has been carried out. The authors have demonstrated that there was a good correlation between the mitral valve area calculated by echocardiographic technique based on the measurement of the distance between the anterior to posterior cusps and that obtained by catheterization using Gorlin formula. The most reliable criteria for mitral commissurotomy was found to be a preserved good amplitude as well as a mild thickening of the anterior cusp. The mean valve of mitral valve orifice areas were compared in both commissurotomy and replacement groups did not show any essential difference (commissurotomy : 2.10+0.97 cm2 versus replacement ; 1.64 +0.31cm2). It was concluded that mitral commissurotomy may provide not only a superior long-term result but also comparable hemodynamic results demonstrated by catheterization as well as by echocardiographic studies. Therefore, the concept of the preservation of diseased mitral valve in so far as possible may be valid in treating dominant or predominant mitral stenosis.
- 札幌医科大学の論文
- 1979-12-01
札幌医科大学 | 論文
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