389例风湿性心脏瓣膜替换术后远期疗效观察

目的 :分析风湿性心脏病瓣膜置换术后远期疗效及其影响因素。方法 :1980年至 2 0 0 0年施行心脏瓣膜置换 4 33例 ,早期死亡 2 7例。术后获访 389例 ,获访时间为 2 16 8病人年 ,平均 5 92病人年。结果 :晚期死亡 35例。晚期死亡率为 1 6 1%病人年。机械瓣和生物瓣晚期死亡率分别为 1 17%和6 10 %病人年 ,15年生存率分别为 89 3%和 4 3 1%。结论 :影响心脏瓣膜置换晚期疗效的主要因素为术前心功、年龄和心房纤颤。机械瓣置换术后晚期死亡原因主要与抗凝有关并发症、心室纤颤、细菌性心内膜炎和心衰有关 ,而生物瓣膜置换术后死亡原因则为生物瓣衰败

Analysis of long-time effricacy after valve replacement for rheumatic heart disease

Objective:This is to analyse the late effect and factors influencing late effect after valve replacement for rheumatic heart disease.Method:From January 1980 to December 2000,valve replacement were performed in 433 patients of rheumatic heart disease.The early death were 27 cases.389 underwent follow\|up,follow\|up time was 2?168 patient\|years,the mean follow\|up time was 5.92 patient\|years.Result:Late death were 35 cases late death rates was 1.61% patient\|years.The 15 years actual survival rates was 89.3% and 43.1%,and late death rates was 1 71% and 6.1% patient\|years for mechanical and biopresthetic respectively.Conclusion:Factors influencing late effect were preoperative cardiac function,age and atrial fibrillation.Cases of late death for mechanical valve replacement were anticoagulation\|related complications,ventricular arrhythmias,bacterial endocarditis and cardiac failure,however for biopresthetic was biopresthetic failure.