二尖瓣及主动脉瓣联合瓣膜置换术112例分析

目的探讨二尖瓣及主动脉瓣联合瓣膜置换术治疗严重联合瓣膜病的临床价值。方法对112例行二尖瓣及主动脉瓣置换术的患者进行回顾性总结和分析，其中风湿性心脏病111例，退行性瓣膜病1例。术前心功能（NYHA）Ⅲ级76例，Ⅳ级12例，再次瓣膜置换8例。均采用胸部正中切口，全部切除二尖瓣90例，保留前瓣2例，保留后瓣10例，保留全瓣10例；术中同时行三尖瓣成形术68例。共置换人工心脏瓣膜224枚。结果手术病死率1．78％，术后早期并发症发生率25．89％。结论二尖瓣及主动脉瓣联合瓣膜置换术是治疗严重联合瓣膜病的最好方法。

Joint mitral and aortic valve replacement surgery:analysis of 112 cases

Objective Explore the issues related to joint mitral and aortic valve replacement surgery. Methods 112 cases of mitral and aortic valve replacement patients, including 111 cases of rheumatic heart disease and 1 case of degenerative valvular disease. Preoperative cardiac function （NYHA） class II1 76 cases, grade IV in 12 cases, 8 cases of valve re-replacement. Using median sternotomy, 90 cases of total resection of mitral valve, 2 cases reserved the front flap, 10 cases reserved the after flap, 10 cases of retained full flap. Line and Tricuspid valve Plast in 68 cases. Replacement heart valve prosthesis 224. Results Operation mortality was 1.78%,The Early postoperative complica- tion rate was 25.89%. Conclusion Joint mitral valve and aortic valve replacement is the best way to treat severe combined valvular dis-ease