702例心脏瓣膜置换术及其主要并发症的临床分析

目的 探讨影响或导致心脏瓣膜置换术围手术期主要并发症的相关因素。方法 对702例心脏瓣膜置换术患者的临床资料进行回顾性分析。结果 本组患者围手术期死亡及主要并发症的发生与术前功能Ⅲ-Ⅳ级,心胸比≥0.70,左心室舒张末内径≥70mm,术中心脏时间过长及体外循环时间过长,术中心肌保护不满意等有关。结论 心脏瓣膜置换术患者围手术期死亡及主要并发症的发生与术前心功能、术中心肌保护、手术方法的选择以及对一些并发症的治疗等有密切关系。

Analysis of complications after cardiac valve replacement: report of 702 patients

OBJECTIVE: To define the determinants of perioperative death and complications after cardiac valve replacement in 702 patients. METHODS: Clinical data of the patients after cardiac valve replacement were analyzed retrospectively. RESULTS: Perioperative mortality and morbidity correlated significantly with some of the perioperative variables, such as higher NYHA functional class (III or IV), large left ventricular end-diastolic diameter (>/= 70 mm), C/T >/= 0.70, prolonged aortic cross-clamping time and cardiopulmonary bypass time, unsatisfactory myocardial protection. CONCLUSIONS: Perioperative mortality and morbidity correlate significantly with some of perioperative variables, such as higher NYHA functional class, unsatisfactory myocardial protection, inappropriate surgical procedure, improper therapy of some complications after cardiac valve replacement. To avoid the occurrence of these independent predictors or to correct them timely might effectively decrease the perioperative mortality and morbidity after cardiac valve replacement.