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目的 探讨营养支持在重症心脏瓣膜病外科治疗中的作用。方法2000年5月-2005年5月对182例重症心脏瓣膜病行瓣膜置换术,围术期采用营养支持疗法。其中单瓣病变74例,二尖瓣合并主动脉瓣病变108例。135例行三尖瓣成形术,37例行左房折叠术。结果 182例住院死亡5例,死亡率2.7%,术后并发低心排15例,死亡1例,随访151例,结论 科学的应用营养支持方案,可以明显地提高重症心脏瓣膜病外科手术成功率。 相似文献
26.
Ashutosh Singh M.Ch. Vidyut Kumar Sinha M.Ch. Jayant Khandekar M.Ch. Nandkishor Agrawal M.Ch. Anil Patwardhan M.Ch. Dr. Jagdish Kharideparkar M.Ch. 《Indian Journal of Thoracic and Cardiovascular Surgery》2006,22(2):121-125
Objective The degree of Left Ventricular Mass Index (LVMI) regression following aortic valve replacement correlates with long-term survival.
This study aims to assess the extent of LVMI regression at 3 months following aortic valve replacement (AVR) with different
types and sizes of mechanical valves in rheumatic aortic valve disease.
Methods The LVMI regression was studied in 34 consecutive patients, undergoing elective AVR for rheumatic aortic stenosis and/or regurgitation.
They were grouped in A and B, matched in age, body surface area and pre-operative LVMI, receiving respectively a tilting disc
and a bileaflet mechanical valve. The LVMI was calculated by M-mode echocardiography using the Devereux' formula pre-operatively
and three months post-operatively. The trend of LVMI reduction was compared between the two groups and amongst the patients
with stenotic, regurgitant and mixed aortic valve, pathologies; and receiving different sizes of valves.
Results The mean preoperative LVMI was 199g±79.5 g/m2. At three months post aortic valve replacement, the mean LVMI was 130g±49.0 g/m2. There was a significant reduction of LVMI post-operatively (p=0.001) at three months follow-up. The extent of LVMI regression
following surgery amongst the groups A and B did not vary significantly (p=0.92). The extent of LVMI regression did not vary
significantly in patients with different aortic valve pathology nor with different sizes of the valves implanted.
Conclusions There is a significant early LVMI regression following aortic valve replacement in rheumatic aortic valve disease. The type
and the size of the mechanical prosthesis or the rheumatic pathology do not appear to influence this regression. 相似文献
27.
Yasuyuki Suzuki Kazuyuki Daitoku Masahito Minakawa Kozo Fukui Ikuo Fukuda 《The Japanese Journal of Thoracic and Cardiovascular Surgery》2006,54(1):44-46
We report the case of a 4-year-old girl who had quadricuspid aortic valve regurgitation with tetralogy of Fallot and pulmonary
atresia. This combination is very uncommon. Aortic valve replacement was performed successfully due to aortic regurgitation
which had progressed one year after the total repair. The dilated aortic annulus plus quadricuspid aortic valve may result
in progressive aortic regurgitation for a short period. 相似文献
28.
主要阐述空调水系统利用平衡阀调节系统阻力,保持系统水力稳定;利用软启动器实施水泵的平滑软启动;压差旁通阀的作用及选型安装;系统管道热膨胀等问题。 相似文献
29.
Dr. Menon Raj Gopal M.Ch. AlDelamie Taha FRCS Valliathu John FRCS Zacharias Sunny FRCS Lawati Al Adil FRCS Venkatraman M.Ch. 《Indian Journal of Thoracic and Cardiovascular Surgery》2006,22(3):173-177
Background Despite improving surgical techniques, treatment of heart valve disease in children remains controversial. Somatic growth
and adequate anticoagulation are of concern when children undergo valve replacement. We conducted this study to evaluate the
performance of valves in this age group.
Methods 42 children under the age of 13 years who underwent valve replacement were included in this study. Totally, 50 valves were
implanted in 42 patients: 48 were mechanical prostheses, two were bioprosthetic both in pulmonary position. 37 (74%) valves
were implanted in mitral position, 10 (20%) in aortic position, 1 (2%) in tricuspid position and 2 (4%) in pulmonary position.
Preoperatively, 14 (33,3%) patients were in New York Heart Association (NYHA) class IV, while 27 (64.2%) were in NYHA class
III.
Results There were 2 (4.7%) hospital deaths and 2 (4.7%) late deaths while 2 (4.7%) patients were lost to follow up. The mean follow
up period was 9.4 yrs. 35 (83.3%) patients are in NYHA Class I and free of all medications except warfarin. 3 (7.1%) patients
have undergone 5 successful pregnancies. The median INR was 2.23. Major thrombo-embolic episode occurred in 1 (2.3%) patient.
Conclusions In view of the problems of sizing, anticoagulation and need for re-operation at an early age, there is a reluctance to replace
valves in children. This study shows that despite these problems, valve replacement can be undertaken safely and successfully
in children, when repair has failed or not technically feasible. 相似文献
30.
C. -E. Jonsson 《European journal of plastic surgery》1993,16(3):143-148
Summary Malposition of the nasal bone, septum and the alar cartilage are striking features of the unilateral cleft nose deformity. An endonasal technique (the extramucosal) was used in 26 patients, aged 13–38 (median 19), to correct aesthetic and functional problems. Twenty-four patients were secondary and two were tertiary. The patients were followed from 1–9 years. The pathological anatomy of the septum varied considerably, so different types of septoplasties had to be done. In 20 patients, satisfactory aesthetic and functional results were obtained in one operation. Secondary corrections were indicated in six patients. In cases with no gross scarring in or around the alar cartilage, the form and position of this cartilage will be more normal once the alar cartilages have been undermined and the deviation of the nasal bone and the septum is corrected. 相似文献