Early And Mid-term Postoperative Comparison Of Left Ventricular Structure And Function Between The Mitral Valvuloplasty And Replacement In Patients With Degenerative Mitral Regurgitation

Objective To compare the left ventricular structure and function changes between the mitral valvuloplasty group and the mitral valve replacement group in the treatment of patients with degenerative mitral regurgitation,and to summarize the left heart structure of the two surgical methods in the early and middle postoperative period.And functional changes and postoperative reflux in the forming group.Methods A retrospective review of 100 cases of degenerative mitral regurgitation in patients with degenerative mitral regurgitation from January 2008 to January 2018 in our Center for Cardiac Cardiovascular Surgery was performed with mitral valvuloplasty and mitral valvuloplasty.Among them,46 patients underwent mitral valvuloplasty and 54 patients underwent mitral valve replacement.The results of color Doppler echocardiography before,one week after,12 months after and 24-36 months after operation were collected.LAD,LVEDD,LVESD,FS were selected as indexes to evaluate left ventricular structure,LVEDVI,LVESVI,SV,EF were used as indexes to evaluate left ventricular function,and the data of mitral regurgitation before and after operation in the plasty group were collected.SPSS 22.0was used for statistical analysis.Results During the 36-month follow-up,mitral valvuloplasty had longer operative time than mitral valve replacement,and the time to block the ascending aorta and extracorporeal circulation was relatively longer.There was no significant difference in left heart structure and function index before operation(P>0.05).In the left heart structure index,LAD,LVEDD,and LVESD were significantly improved in the mitral valvuloplasty group and the replacement group(P<0.05),and the FS postoperatively improved significantly in the two groups(P<0.05).<0.05),and there was no significant difference between the FS after 12 months and 24-36(29.35±9.78)months before surgery(P>0.05).There were no significant differences between the two groups in the early stage after LAD,LVEDD,LVESD,and FS(P>0.05).There were significant differences in LAD,LVEDD,LVESD,and FS between the two groups after 24-36 months of follow-up.(P<0.05,P<0.01,P<0.05,and P<0.01,respectively).Among the left heart function indexes,LVEDVI,LVESVI,and SV were significantly improved in the early and middle postoperative period compared with preoperative(P<0.05).There was no significant difference between the two groups after SV(P>0.05).0.05),only 12 months after surgery and 24-36 months compared with the week after surgery,there was a significant improvement(P<0.05).There were no significant differences between the two groups(P>0.05).There were significant differences between the two groups(P<0.05).There was no significant difference in the degree of reflux between the angioplasty group and the postoperative 24-36 months after surgery(P>0.05).Conclusion 1.Mitral valvuloplasty and mitral valve replacement in the treatment of patients with degenerative mitral regurgitation can not only effectively improve the left ventricular structure and function,but also reduce the patient's reflux to zero/minimal.2.Compared with mitral valve replacement,mitral valvuloplasty requires longer cardiopulmonary bypass time and ascending aorta occlusion time.3.In terms of left ventricular structure and indicators,the improvement and recovery of the plasty group were significantly better than those of the replacement group,and the plasty group did not need lifelong anticoagulation and had a higher quality of life.4.Mitral valvuloplasty can improve mitral regurgitation steadily for a long time.