بررسی تغییر وضعیت پرولاپس دریچه میترال در بیماران دچار نقص دیواره بین دهلیزی بعد از بستن نقص دیواره

نوع مقاله : مقاله پژوهشی

نویسندگان

1 دانشیار گروه قلب و عروق، دانشکده پزشکی، دانشگاه علوم پزشکی مشهد، مشهد، ایران

2 پزشک عمومی، دانشکده پزشکی ،دانشگاه علوم پزشکی مشهد،مشهد، ایران.

3 استادیار گروه قلب و عروق، فلوشیپ اکوکاردیوگرافی، مرکز پژوهشی جراحی عروق، بیمارستان امام رضا ع، دانشکده پزشکی ،دانشگاه علوم پزشکی مشهد،مشهد، ایران.

4 استادیار واحد توسعه بالینی دانشکده پزشکی ،بیمارستان قائم عج، دانشکده پزشکی ،دانشگاه علوم پزشکی مشهد،مشهد، ایران

چکیده

مقدمه
با توجه به شیوع و اهمیت بالای بیماری­های مادرزادی قلبی و به خصوص نقص دیواره­ی بین دهلیزی و تاثیر شگرف این اختلالات بر سلامت و طول عمر بیماران، شناخت بیشتر آن­ها از ضروریات به شمار می­رود. این اختلالات می توانند همراه با سایر مشکلات عملکردی و ساختاری قلب باشند. تا کنون مطالعات محدودی به تاثیرنقص دیواره­ی بین دهلیزی بر مشکلات ساختاری دریچه میترال پرداخته اند.
 
روش کار
 در مطالعه­ی حاضر تمام بیماران دچار نقص دیواره بین دهلیزی (ASD) که از شهریور 1396 لغایت شهریور 1397 به بیمارستان قائم و امام رضای مشهد مراجعه کرده و کاندید بستن نقص دیواره بین دهلیزی شده بودند وارد مطالعه شدند. داده­های دموگرافیک جمع­آوری شدند. اکوکاردیوگرافی دو بعدی قبل و بعد از عمل جراحی انجام شد.
نتایج
تعداد کل بیماران مورد مطالعه 41 نفر بود و شیوع پرولاپس دریچه میترال در بیماران 2/51 درصد گزارش شد. همچنین نتایج مطالعه حاضر نشان داد که در 05/19 درصد از بیمارانی که در بدو مطالعه پرولاپس دریچه میترال داشتند، پس از عمل جراحی پرولاپس مشاهده نشد و میانگین و انحراف معیار سایز بطن راست، سایز دهلیز راست و فشار شریان ریه بعد از عمل به طور معناداری کمتر از قبل از عمل بود.
   نتیجه گیری
نتایج مطالعه حاضر نشان داد که برخی از تغییرات ساختاری دریچه میترال می تواند بواسطه اثر اندازه و شکل بطن راست بر بطن چپ از طریق سپتوم بین بطنی باشد که پس از بسته شدن نقص سپتوم بین دهلیزی، این تغییرات می تواند در برخی از موارد بازگشت پذیر باشد.

کلیدواژه‌ها

عنوان مقاله [English]

The change in mitral valve prolapse after atrial septal defect closure procedure

نویسندگان [English]

  • Hoorak Poorzand 1
  • Amirhosein Attarbashi 2
  • Leila Bigdelu 3
  • Hasan Mehrad Majd 4
  • Hediye Alimi 3
1 cardiovascular department, Faculty of Medicine, Mashhad university of medical sciences, Mashhad,Iran
2 general practitioner, Faculty of medicine, Mashhad university of medical science, Mashhad, Iran.
3 Assistant Professor of Cardiovascular Department, Echocardiography Fellowship, Vascular Surgery Research Center, Imam Reza Hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
4 Assistant professor, Ghaem Hospital. Faculty of medicine, Mashhad University of medical science, Mashhad, Iran.
چکیده [English]

Introduction: Congenital heart disease could have effect on life expectancy and may be associated with other anomalies causing hemodynamic abnormality which regress after resolving the shunt. The purpose of this study was to investigate the change in the mitral valve prolapse after defect closure in patients with atrial septal defect.
Methods & Materials: This study including all patients with atrial septal defect (ASD) who referred to Ghaem and Imam Reza Hospital in Mashhad from September 2017 to September 2018, and had been candidates for atrial septal defect closure. Demographic data were collected. Two-dimensional echocardiography was done before and after defect closure procedure. Exclusion criteria including patients with suboptimal echocardiography view and post procedure residual shunt.
Results: The results of this study showed in patients with atrial septal defect, the prevalence of mitral valve prolapse was 51.2%. Also, 19.05% of patients with mitral valve prolapse before the defect closure procedure, did not have any prolapse after the procedure. On the other hand, the mean and standard deviation of right ventricle and right atrium size and pulmonary artery pressure after the procedure were significantly lower than values before the procedure.
Conclusion: The results of this study indicated, in the presence of ASD, right ventricular (RV) volume overload by effect on left ventricle, could cause mitral valve structural abnormality. This abnormality could be regress after ASD closure and resolving of shunt effect on RV.

کلیدواژه‌ها [English]

  • Mitral Valve Prolapse
  • Atrial Fibrillation
  • Congenital Heart Disease

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مجله دانشکده پزشکی دانشگاه علوم پزشکی مشهد
دوره 63، شماره 2
خرداد و تیر 1399
صفحه 2262-2271

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