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僧帽弁逸脱症に対する弁形成術
https://uoeh-u.repo.nii.ac.jp/records/718
https://uoeh-u.repo.nii.ac.jp/records/7189118a882-ce97-4158-8d2a-b0246d915ee2
名前 / ファイル | ライセンス | アクション |
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S00037305 (2.1 MB)
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Item type | 学術雑誌論文 / Journal Article(1) | |||||
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公開日 | 2020-08-03 | |||||
タイトル | ||||||
タイトル | 僧帽弁逸脱症に対する弁形成術 | |||||
タイトル | ||||||
言語 | en | |||||
タイトル | Mitral Valve Repair for Patients with Mitral Valve Prolapse | |||||
言語 | ||||||
言語 | jpn | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | 僧帽弁逸脱症 | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | 手術 | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | 僧帽弁形成術 | |||||
キーワード | ||||||
言語 | en | |||||
主題Scheme | Other | |||||
主題 | mitral valve prolapse | |||||
キーワード | ||||||
言語 | en | |||||
主題Scheme | Other | |||||
主題 | surgery | |||||
キーワード | ||||||
言語 | en | |||||
主題Scheme | Other | |||||
主題 | mitral valve repair | |||||
資源タイプ | ||||||
資源タイプ識別子 | http://purl.org/coar/resource_type/c_6501 | |||||
資源タイプ | journal article | |||||
記事区分 | ||||||
値 | 総説 | |||||
著者 |
西村 , 陽介
× 西村 , 陽介× Nishimura, Yosuke |
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抄録 | ||||||
内容記述タイプ | Abstract | |||||
内容記述 | 心臓弁膜症に対する外科治療は人工弁による弁置換術が主流であった.しかし,人工弁置換術を行えば,血栓塞栓症・出血・人工弁感染・人工弁劣化などの人工弁関連合併症は不可避となる.それに対して弁形成術はこれらの合併症が回避できるのみならず,内服薬も不要となり,健康人同様のQuality of Lifeを得ることも可能である.弁形成術は腱索再建術などより複雑な手技を要することや,逆流の残存や再発・増悪などの問題点もあるが,僧帽弁逸脱による僧帽弁閉鎖不全症は形成術のよい適応である.現在行われている手術術式としては人工弁輪による弁輪形成術を基本術式として,後尖逸脱に対しては矩形切除術・三角切除術などの弁尖切除術,収縮期前方運動(systolic anterior movement: SAM)予防のためのスライディング法などが,また前尖逸脱に対しては弁尖切除や腱索短縮術,後尖腱索の移動術などが行われていたが,近年ではePTFE(expanded polytetrafluoroethylene)糸を用いた人工腱索による腱索再建術が多く行われている.僧帽弁逸脱症に対する弁形成術の遠隔成績は人工弁置換術との比較検討にてその優位性が報告されており,再手術の頻度も弁置換術と変わらず10年で7-10%と良好である. Prosthetic valve replacement has mainly been performed on patients with mitral regurgitation. In such cases, prosthetic valve related complications, such as thromboembolism, bleeding, prosthetic valve infection, and structural valve deterioration, are unavoidable. With valve plasty, however, not only can such complications be avoided, but patients can also have as good a quality of life as healthy people without medications. Although mitral valve plasty requires complicated techniques like chordal reconstruction and has problems of residue, recurrence, and progression of regurgitation, patients with mitral valve prolapse are considered to be good candidates for this procedure. Mitral annuloplasty with a prosthetic ring is the essential and basic procedure of this operation, usually adding to the other techniques. Resection and suture methods of quadrangular resection, triangular resection and the sliding method, by which systolic anterior movement can be avoided, are indicated for patients with posterior leaflets prolapse. The resection and suture method, chordal shortening, and chordal transposition were previously done on patients with anterior leaflets prolapse, but recently chordal reconstruction using ePTFE (expanded polytetrafluoroethylene) is performed. Superior long-term results of mitral valve plasty for patients with mitral valve prolapse compared to prosthetic valve replacement have been reported. The 10-year reoperation rate of mitral valve plasty is only 7-10% as much as valve replacement. |
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書誌情報 |
産業医科大学雑誌 en : Journal of UOEH 巻 37, 号 3, p. 195-202, 発行日 2015-09-01 |
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出版者 | ||||||
出版者 | 産業医科大学(産業医科大学学会) | |||||
ISSN | ||||||
収録物識別子タイプ | ISSN | |||||
収録物識別子 | ISSN 0387-821X(PRINT), ISSN 2187-2864(ONLINE) | |||||
関連サイト | ||||||
識別子タイプ | URI | |||||
関連識別子 | https://www.uoeh-u.ac.jp/kouza/journal/intro_e.html | |||||
関連名称 | Journal of UOEH | |||||
関連サイト | ||||||
識別子タイプ | URI | |||||
関連識別子 | https://www.uoeh-u.ac.jp/kouza/journal/intro_j.html | |||||
関連名称 | 産業医科大学雑誌 | |||||
著者版フラグ | ||||||
出版タイプ | VoR | |||||
出版タイプResource | http://purl.org/coar/version/c_970fb48d4fbd8a85 |