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保留瓣下结构     
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  preservation of subvalvular apparatus
     Conclusion: Early operation (especially before LVDs≤6 0 cm or ESV≤150 ml), and preservation of subvalvular apparatus during MVR are in favor of left ventricular geometry reversal and systolic function improvement for patients with GLV due to severe chronic mitral regurgitation.
     结论 对于二尖瓣关闭不全合并巨大左室者 ,争取尽早手术 (LVDs≤ 6 0cm或ESV≤ 15 0ml前 )以及术中保留瓣下结构 ,有利于术后左心室形态的逆转和左心收缩功能的恢复。
短句来源
     Influence on left heart function after mitral valve replacement with preservation of subvalvular apparatus
     保留瓣下结构对二尖瓣置换术后左心功能的影响
短句来源
     Influence on regional wall motion of left ventricle after mitral valve replacement with or without preservation of subvalvular apparatus
     保留瓣下结构对二尖瓣置换术后室壁运动的影响
短句来源
     Methods All 44 patients were randomly divided two groups. Group A: Mitral valve replacement with entire preservation of subvalvular apparatus; Group B: Mitral valve replacement with partial preservation of subvalvular apparatus.
     方法 随机选取 4 4例接受二尖瓣置换术的患者 ,随机分为两组 ,A组接受全部保留瓣下结构的二尖瓣置换术 ,B组接受部分保留瓣下结构的手术 ,比较两组在术后早期的血流动力学变化和术后 3个月及 6个月的超声心动图改变。
短句来源
     Objective To study the effects of mitral valve replacement (MVR) with or without preservation of subvalvular apparatus on left ventricular function.
     目的 采用声学定量技术对慢性二尖瓣反流患者进行检测 ,旨在评价二尖瓣替换术 (MVR)保留瓣下结构对左心舒缩功能的影响。
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  subvalvular structure preservation
     Early Results of Mitral Valve Replacement With Subvalvular Structure Preservation
     保留瓣下结构的二尖瓣替换术后早期效果观察
短句来源
     Methods:Twenty six patients underwent mitral valve replacement in our hospital were studied,among them 22 with mitral stenosis underwent mitral valve replacement with partial subvalvular structure preservation and the rest with mitral insufficiency underwent mitral valve replacement with entire subvalvular structure preservation.
     方法:总结了保留瓣下结构的二尖瓣替换术26例,其中部分保留22例为二尖瓣狭窄,完全保留4例为二尖瓣关闭不全。
短句来源
     Results:Comparing with another group of 26 patients(mitral stenosis) underwent mitral valve replacement with entire subvalvular structure resection,the patients with subvalvular structure preservation had much less postoperative low cardiac output complications,more left atrial dimension reduction and no occurrence of left ventricular rupture,but no significant difference in the other five measured indexes.
     结果:与同期完全切除的26例(均为二尖瓣狭窄)比较,保留瓣下结构者术后低心输出量综合征发生率较低,左心房缩小较明显,未发生左心室破裂。 其余5项指标两组间无差异。
短句来源
     Conclusions:This study suggests that for patients with mitral insufficiency mitral valve replacement with entire subvalvular structure preservation is preferable,while intravalvular implantation of mitral prosthesis is simpler and safer.
     结论:二尖瓣关闭不全者应完全保留瓣下结构,其中将人工瓣置入二尖瓣口内更为简便安全。
短句来源
     Subvalvular structure preservation and tricuspid annuloplasty contribute can greatly improved heart function.
     与术前心功能和手术种类直接相关 ; 2 .使用保留瓣下结构及三尖瓣成形术对术后心功能恢复有明显效果 ;
短句来源
  reserved subvalvular structure
     Mitral valve Replacement by Reserved Subvalvular Structure
     保留瓣下结构的二尖瓣替换术
短句来源
  “保留瓣下结构”译为未确定词的双语例句
     With the recognization of physiological function of mitral apparatus and the relation to left ventricular function, based on conventional mitral valve replacement ( MVRC) , a new concept is being accepted : mitral valve replacement with preservation of subvalvalar apparatus (MVRP).
     随着人们对二尖瓣装置的生理作用及其与左心室功能关系的深入研究,在切除瓣下结构的传统二尖瓣置换术(conventional mitral valve replacement,MVRC)基础上提出了保留瓣下结构的二尖瓣置换术(mitral valve replacement with preservation of subvalvular apparatus,MVRP)。
短句来源
     Experience in nursing for 65 patients with mitral valve replacement by chordal preservation
     保留瓣下结构二尖瓣置换术65例护理体会
短句来源
     As to bileaflet valve, I rel of the group with preservation of posterior subvalvular apparatus and of the other one without preservation were lower than that of the group with preservation of total subvavular apparatus(p<0.05).
     对于双叶瓣 ,保留后瓣瓣下结构组 (保留后瓣组 )和未保留瓣下结构组 (未保留组 )之Irel均低于保留全瓣瓣下结构组 (保留全瓣组 ) (p<0 .0 5 ) ;
短句来源
     As to monoleaflet disc,there was a significant difference for the magnitude of TSS between the groups of preservation of total,posterior subvalvular apparatus and of non-preservation(P<0.05).
     对于单叶瓣,TSS在保留全瓣瓣下结构组(保留全瓣组)、保留后瓣瓣下结构组(保留后瓣组)与未保留瓣下结构组(未保留组)间均存在显著差异(P<0.05)。
短句来源
     Objective To compare the routine mitral valve replacement(MVR) with MVR with preservation of the mitral complex on early postoperative hemodynamics.
     目的比较常规二尖瓣置换术(MVR)与保留瓣下结构的二尖瓣置换术(MVRP)对术后早期血流动力学的影响。
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  preservation of subvalvular apparatus
We report a female patient with mitral valve replacement and preservation of subvalvular apparatus in which parts of the papillary muscle ruptured postoperatively.
      


Objective:Left ventricular function often deteriorates after conventional mitral valve replacement for mitral regurgitation.It has been postulated that disruption of the mitral valve apparatus at operation is a major cause of postoperative dysfunction.This study was aimed to study the result of subvalvular structure preservation in mitral valve replacement. Methods:Twenty six patients underwent mitral valve replacement in our hospital were studied,among them 22 with mitral stenosis underwent mitral valve...

Objective:Left ventricular function often deteriorates after conventional mitral valve replacement for mitral regurgitation.It has been postulated that disruption of the mitral valve apparatus at operation is a major cause of postoperative dysfunction.This study was aimed to study the result of subvalvular structure preservation in mitral valve replacement. Methods:Twenty six patients underwent mitral valve replacement in our hospital were studied,among them 22 with mitral stenosis underwent mitral valve replacement with partial subvalvular structure preservation and the rest with mitral insufficiency underwent mitral valve replacement with entire subvalvular structure preservation. Results:Comparing with another group of 26 patients(mitral stenosis) underwent mitral valve replacement with entire subvalvular structure resection,the patients with subvalvular structure preservation had much less postoperative low cardiac output complications,more left atrial dimension reduction and no occurrence of left ventricular rupture,but no significant difference in the other five measured indexes. Conclusions:This study suggests that for patients with mitral insufficiency mitral valve replacement with entire subvalvular structure preservation is preferable,while intravalvular implantation of mitral prosthesis is simpler and safer.Some of the patients with mitral stenosis should receive mitral valve replacement with posterior leaflet and subvalvular structure preservation,however for patients with severe lesion of the leaflets the entire subvalvular structure should be resected.

目的:二尖瓣关闭不全患者行常规二尖瓣替换术后常有左心室功能恶化,有作者推测术中二尖瓣结构的破坏是导致术后左心室功能不全的主要原因之一。本文旨在探讨保留瓣下结构的影响。方法:总结了保留瓣下结构的二尖瓣替换术26例,其中部分保留22例为二尖瓣狭窄,完全保留4例为二尖瓣关闭不全。结果:与同期完全切除的26例(均为二尖瓣狭窄)比较,保留瓣下结构者术后低心输出量综合征发生率较低,左心房缩小较明显,未发生左心室破裂。其余5项指标两组间无差异。结论:二尖瓣关闭不全者应完全保留瓣下结构,其中将人工瓣置入二尖瓣口内更为简便安全。部分二尖瓣狭窄者可保留后瓣及瓣下结构,而瓣叶和瓣下结构病变严重者则应完全切除。

patientsaftermitralvalvereplacementwithpartialsubvalvularstructurepreservationand20patientswithentiresubvalvularstructurepreservationwerecomparedofwith26patientsaftermitralvalvereplacementwithentiresubvalvularstructureexcision.Wefoundthatpatientsaftermitralvalvereplacementwithpartialorentiresubvalvularstructurepreservationhadamoreuneventfulpost-operativecoursewithlessinotropictherapyandmoredecreasedleftatrialdimensionwhencomparedtothosewithconventionalmitralvalvereplacement.Butthepatientsaftermitralvalvereplacementwithentiremitralstructurepreservationhadmoredecreasedleftventriculardimensionandshorthospitalstaywhencomparedtothoseoftheothertwogroups.Theauthorssuggestthatmitralsubvalvularstructureshouldbepreserved,andweespecialyrecommendtheprocedureofintravalvularimplantationofmitralprosthesiswithentiremitralsubvalvularstructurepreservation....

patientsaftermitralvalvereplacementwithpartialsubvalvularstructurepreservationand20patientswithentiresubvalvularstructurepreservationwerecomparedofwith26patientsaftermitralvalvereplacementwithentiresubvalvularstructureexcision.Wefoundthatpatientsaftermitralvalvereplacementwithpartialorentiresubvalvularstructurepreservationhadamoreuneventfulpost-operativecoursewithlessinotropictherapyandmoredecreasedleftatrialdimensionwhencomparedtothosewithconventionalmitralvalvereplacement.Butthepatientsaftermitralvalvereplacementwithentiremitralstructurepreservationhadmoredecreasedleftventriculardimensionandshorthospitalstaywhencomparedtothoseoftheothertwogroups.Theauthorssuggestthatmitralsubvalvularstructureshouldbepreserved,andweespecialyrecommendtheprocedureofintravalvularimplantationofmitralprosthesiswithentiremitralsubvalvularstructurepreservation.

为提高二尖瓣置换术的疗效,作者对部分保留瓣下结构的二尖瓣置换术(MVR)21例、完全保留瓣下结构20例,分别与同期完全切除瓣叶和瓣下结构者26例比较。结果表明,部分或全部保留瓣下结构者术后病情较平稳,较少需要血管活性药物,左房内径缩小较多,不易发生左心室破裂;与另两组相比,完全保留组术后早期左心室缩小更明显,术后住院时间也较短。作者建议尽可能部分保留瓣下结构,尤推荐完全保留瓣叶和瓣下结构,二尖瓣口内置入人工瓣即所谓瓣中瓣MVR。

ecords of 1000 patients [548 males , 452 females ; aged 4 to 57 years (median 33.1 years ) ] , who underwent valve replacement for cardiac valve diseases at the First Affilated Hospital , Sun Yat-sen University of Medical Sciences from June , 1976 through October , 1994 were reviewed. Functional capacity could be assessed preoperatively: 91 were in class Ⅱ, 528 in Ⅲ, and 381 in Ⅳ. On operation, isolated MVR were performed in 660 cases (66%). AVR in 128 (12.8%), MVR accompanied with AVR in 206 (20. 6%). Postopera-...

ecords of 1000 patients [548 males , 452 females ; aged 4 to 57 years (median 33.1 years ) ] , who underwent valve replacement for cardiac valve diseases at the First Affilated Hospital , Sun Yat-sen University of Medical Sciences from June , 1976 through October , 1994 were reviewed. Functional capacity could be assessed preoperatively: 91 were in class Ⅱ, 528 in Ⅲ, and 381 in Ⅳ. On operation, isolated MVR were performed in 660 cases (66%). AVR in 128 (12.8%), MVR accompanied with AVR in 206 (20. 6%). Postopera- tively , 249 patients had early complications (24.9%) and early mortality rate was 9.5%(95 cases) , in whom 31 were class Ⅱ or Ⅲ (4. 4%) , 64 were Ⅳ(16. 8%). However , the opera- tive mortality was 10. 30% (31 cases) before 1991 and then it had a significant decreasin ter 1992 (6. 6% , 14 cases). Mean follow-up time was 7. 8 year, marked improvement of car- diac function was found in survived patients. There were 127 late deaths ( 1. 8%) patient - year). A detailed discussion of clinical experience is given. The authors concluded that the following are important to improve the postoperative results ; choosing proper operative chance , developing cardiopulmonary bypass technique , intensifying myocardial protection , performing MVRP to suitable patients , pay attention to postoperative management and treat early complications in time.

1976年6月~1994年10月,作者为1000例心脏瓣膜病患者施行了瓣膜替换术。术前心功能Ⅱ级91例,Ⅲ级528例,Ⅳ级381例。手术方式:二尖瓣替换术(MVR)660例(66%)。主动脉瓣替换术(AVR)128例(12.8%),主动脉瓣及二尖瓣同期替换术(AVR及MVR)206例(20.6%),三尖瓣替换术(TVR)6例(0.6%)。术后早期并发症249例(24.9%),早期死亡95例(9.5%)。其中心功能Ⅱ~Ⅲ级者早期死亡31例(4.4%),心功能Ⅳ级者早期死亡64例(16.8%),有非常显著的差异(P<0.01)。1991年以前手术的病人死亡81例(10.3%),1992年以后手术的病人手术死亡14例(6.6%)。术后随访3个月~18.6年,平均7.8年,晚期死亡127例(1.8%病人年),存活病人心功能明显改善。作者认为,选择适当的手术时机,完善和改进体外循环技术,加强术中的心肌保护,对适宜病例施行保留瓣下结构的二尖瓣替换手术(MVRP)及加强术后监护,及时处理早期并发症是提高手术疗效的重要措施。

 
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