合并大左室瓣膜置换术的外科治疗体会

目的总结合并大左室瓣膜病的治疗经验。方法1998年4月～2004月年对28例合并大左室瓣膜病人行瓣膜置换术。其中二尖瓣置换术13例,主动脉瓣置换术13例,主动脉瓣和二尖瓣双瓣置换术1例,Bentall手术1例;同期处理并存畸形及病变7例。结果治愈出院25例,术后早期死亡3例。合并症22例,其中心律失常20例、低心排出量综合征2例。结论充分的术前准备,恰当的手术处理,术后积极防治恶性心律失常和低心排出量综合征是提高手术效果的关键。

SURGICAL TREATMENT OF MECHANICAL VALVE REPLACEMENT TO THE PATIENTS WITH ENLARGED LEFT VENTRICLE:A REPORT OF 28 CASES

Objective To analyze the experience of the surgical treatment of valvular heart disease with enlarged left ventricle. Methods Valvular operations were performed in 28 patients with enlarged left ventricle from April,1998 to July,2004,including mitral valve replacement in 13 cases, aortic valve replacement in 13 cases,combined mitral and aortic valve replacement in 1 case, and Bentall operation in 1 case. Other procedure has done in the same stage including closures for Atrial Septal Defect(ASD) in 2 cases ,Ventricular (VSD) in 1 case and Kay procedure for tricuspid valve regurgitation in 4 cases. Results Among 28 cases, early death occurred in 3 patients, remaining 25 patients were cured .The postoperative complications were caused in 22 patients including arrhythmia in 20 cases,low output syndrome in 2 cases. Conclusion The key to improve the early result of these kinds of patients are to strengthen the perioperative management,to adopt appropriate procedure,to prevent and treat postoperative complications, especially such arrhythmia and low output syndrome effectively.