KỸ THUẬT NỚI RỘNG MÔ VAN BẰNG MÀNG NGOÀI TIM TỰ THÂN TRONG ĐIỀU TRỊ HỞ VAN HAI LÁ HẬU THẤP

Abstract

Background and aim of the study: To present long-term follow-up results of Leaflet Augmentation with Autologus Pericardium for Mitral Valve Repair.
Materials and Methods: From 1992 to 2008, 221 patients underwent mitral valve repair by the technique of Leaflet Augmentation with Autologus Pericardium in the Heart Institute of Ho Chi Minh, Vietnam. Valve disease was rheumatic in most cases. Age ranging of patients from 7months to 54 years. Mean follow-up was 86 ± 2,61 months.
Results: Anterior leaflet extension (84%) is preferred to posterior leaflet extension (16%). Transverse patch (92%) compared with vertical patch (8%). Non-fatal complication: Bacterial endocarditis (4 cases); Reoperation including: Patch dehiscence (2 cases), Endocarditis (2 cases), Leaflet retraction by patch shrinkage (4 cases), and Calcified pericardial patch (18 cases). 14 young children underwent anterior leaflet extension for the size of ring up to 20 (4 cases), 22 (4 cases), 24 (6 cases). Operative mortality was 1,2% overall. Deaths, often related to cardiac insufficiency. Late survival rate at 10 years was 95,4 ± 0,8%. Freedom from re-operation at 10 years was 89,1 ± 0,8%. The grades of mitral regurgitation at 10 years were 77% absent or mild, 18% moderate, and 5% severe.
Conclusions: This study showed excellent mortality and morbidity outcomes with Leaflet Augmentation with Autologus Pericardium for Mitral Valve Repair over a 10-year follow-up, confirming reliablility and durability of this technique for the patients. This showed a good solution for rheumatic MR and young children by safe technique, and increase feasibility of repair for rheumatic valve. Good pericardial preservation helps good longterm result and high surgical expertise as well. *