重度二尖瓣狭窄伴小左室28例围手术期观察

目的探讨重度二尖瓣狭窄伴小左室病人围手术期治疗的特点。方法对本院2000年1月至2006年7月114例风湿性心脏病二尖瓣病变行二尖瓣替换术（MVR）的病人中重度二尖瓣狭窄伴小左室28例进行回顾性分析。结果术后机械通气时间（h）延长、心律失常、低心排、肺部并发症及早期病死率的发生率均增加，同时术后近期左室容积和收缩功能均有不同程度的改善。结论重度二尖瓣狭窄伴小左室虽然是手术的高危指标，但并非手术禁忌，术中选用较小型号的瓣膜并注意心肌保护，加强围术期处理是手术成功的关键。

Surgical treatment of severe mitral stenosis associated with small left ventricle

Objective To explore the perioperative features of surgical treatment in patients of severe mitral stenosis associated with small left ventricle. Methods MitraI valve replacements(MVRs) were undertaken in 114 patients with rheumatic heart disease(RHD)displaying mitral valve involvement from January 2000 to July 2006.28 patients out of them belonging to SMS associated with small left ventricle were analyzed retrospectively. Results Postoperative mortality was obviously higher than that in patients of mitral stenosis without small left ventricle. The postoperative incidence of low cardiac output syndrome was higher than it too. Conclusion Although SMS associated with small left ventricle may be considered as a high risk factor for MVR,but it is not surgical contraindication.The key points of successful operation depend on the choice of smaller valves,paying attention to protection of myocardium and the intensification of perioperative management.