巨大心脏瓣膜置换术的临床研究

目的:总结合并巨大心脏瓣膜病行心脏瓣膜置换术的疗效,探讨影响手术疗效的高危因素,手术适应症,围手术期处理.方法:1999年6月至2004年6月共为16例合并巨大心脏(CTR＞0.7)的瓣膜病行心脏瓣膜置换术,其中双瓣置换术12例、二尖瓣置换术2例、主动脉瓣置换术2例,同时行三尖瓣Devega成形术2例,均选用机械瓣.结果:术后早期死亡2例,1例并发肾功能衰竭,多器官功能衰竭死亡.1例并发恶性室性心律失常死亡,死亡率为12.2%,14例生存,术后6个月时心功能明显改善.结论:提高手术疗效,降低手术并发症及死亡率的关键是把握手术时机、完善的围手术期处理.

The clinical study of valvular replacement in large heart disease

Objective:To reseach the risk factor,adaption of operation ,the manegement of perioperation according to the effect of large valvular replacement . Method: 16 cases with valvular disease in large heart were adopted valvular replacement from June 1996 to June 2004,among them, 12 cases double valvular replacement, 2 cases mitral valve replacement, 2 cases aortic valve replacement , 2 cases with tricuspid valve Devega plastic , all above used mechnical valvular.Result:2 cases died after operation, one complicated with kidney function failure andthen died of MOF. one died of complicating with severe arrhythmia , the death rate is 12.2% , 14 cases survived.The heart function improved obviously after operation of 6 months.Conclusion: The key to decrease the complication and the death rate is to contral the operation time and perfect the manegement of the the perioperation.