瓣膜置换治疗心脏瓣膜病合并巨大左心室临床研究

目的总结合并巨大左心室瓣膜置换术的治疗经验。方法对2002年4月-2009年2月施行的65例巨大左心室瓣膜置换术的临床资料进行回顾性分析。结果术后发生各种并发症33例（50.77%）,死亡5例（7.69%）。恶性室性心律失常和低心排综合征及其所导致的多脏器功能衰竭是合并巨大左室瓣膜置换术后的主要并发症和致死原因。结论合并巨大左室瓣膜置换术后的并发症和死亡率均明显高于同期瓣膜病手术,但瓣膜置换术仍是治疗合并巨大左心室瓣膜病的首选方法,充分的术前准备、适当地选择手术时机、正确的手术方法及合理的围术期处理是获得良好手术效果的重要因素。

Valve replacement of valvular heart disease with giant left ventricle

Objective To summarize the experience of valve replacement operation for the patients with giant left ventricle （LVEDD ≥70mm）. Methods Sixty -five patients with giant left ventricle underwent valve replacement operation from April 2002 to February 2009 were analyzed retrospectively. Results There were 33 eases with early postoperative complications （ 50.77% ） , and 5 cases died, mortality was 7.69%. Malignant ventricular arrhythmia and low cardiac output syndrome （LCOS） and multiple organal failure （MOF） are principal complications and obituary causes. Conclusion Valve replacement should be the preferred mode of surgical correction for valvular heart disease with giant left ventricle. The better effects would be achieved with proper indication, full preoperative preparation, selection of surgical techniques and proper perioperative management.