Mitral Valve Surgery - Surgery Series, 2/2/21
31:56-34:33
For many years the debate, I won't get into too much detail, but the debate had been repair of the mitral valve versus replacement and is repair gonna last and so many, many studies in the 80s and the 90s showed that repair was preferable to replacement and much of the 2000s then was devoted to studies looking at techniques that could refine those repair, those repair procedures.
深入りはしませんが、何年にも渡り、「僧帽弁の修復術と置換術ではどちらを選択すべきか？」「修復した場合は結果が持続するのか？」といった議論が交わさました。80年代、90年代に行われた多くの研究で、修復の方が置換よりも望ましいことが示されました。2000年代はほぼ、修復術を改良する技術についての研究に費やされました。
I mentioned one study here that Dr. Cameron was involved in, in the mid 90s and it looked at, this was a group of all Marfan patients who, a retrospective review, who had cardiac surgery and 36 of these patients had mitral procedures, 29 repairs and 7 replacements. It was a combination of men and women and they were all young, I mean, this is mid population and generally in their mid-20s and some and seven of them were less than 18.
ここで紹介するのは、90年代半ばにDuke先生が携わった研究です。この研究は、心臓手術を受けたマルファン患者を対象としたレトロスペクティブレビューです。対象となった患者さんで僧帽弁の手術を受けたのが36人で、29人が修復術、7人が置換術でした。男女混合で、大部分は20代半ばで、18歳未満は7人でした。
So 24 of the 29 who had repair of their mitral valve also had root replacement at the same time and really the success was very high. So at five years, this was an early follow-up interval, but at five years they found that, that 88.3 percent essentially were significant of, were free from significant mitral regurgitation.
修復術を受けた29人中の24人は、同時に大動脈基部の置換術も受けており、非常に高い成功率でした。最初のフォローアップ間隔である5年目の時点で、88.3%の方が重篤な僧帽弁逆流を生じていませんでした。
A later study in 2006 looking at Marfan folks versus people with mitral regurgitation from non-Marfan from non-syndromic reasons, which is more generically called myxomatous mitral valve degeneration, so this was a study of 27 patients with Marfans and 119 with, with non-syndromic mitral regurgitation. This was an older group in general both for the Marfans and then and then the mixominous, myxomatous crowd was even older and there's more advanced mitral regurgitation at the time of of these surgeries.
それより後の2006年の研究では、マルファン患者と、非マルファンで非症候性の僧帽弁逆流の患者を比較しました。後者の所見はより一般的に、僧帽弁粘液腫様変性とよばれています。この研究は、27例のマルファン患者と119例の非症候性の僧帽弁逆流の患者を比較したものです。両群とも全体的に高齢でしたが、非症候性群は、より年齢が高く、手術の時点でより進行した僧帽弁逆流がみられました。
There's less repair in those with Marfan than in myxomatous but in general another success story for repair where at the 10-year mark survival was 80 and the freedom from re-operation was 96 percent and only one among the 16 Marfan's folks had needed re-operation so 15 out of 16 of the Marfan repairs were in good shape at the 10-year mark.
僧帽弁粘液様変性の患者よりもマルファン患者のほうが修復術を受けた人数は少なかったのですが、16例のマルファン患者において10年後の時点で生存率80%で、再手術が不要だったのは96%でした。つまり、マルファン患者16例中の15例で10年後の時点で修復結果が良好であったということです。
The Marfan Foundation did not participate in the translation of these materials and does not in any way endorse them. If you are interested in this topic, please refer to our website, Marfan.org, for materials approved by our Professional Advisory Board.
The Marfan Foundation は、当翻訳には関与しておらず、翻訳内容に関してはいかなる承認も行っておりません。このトピックに興味をお持ちの方は、Marfan.org にアクセスし、当協会の専門家から成る諮問委員会が承認した内容をご参照ください。
