人工心脏瓣膜替换术后瓣周漏18例

人工心脏瓣膜替换术后瓣周漏是一种严重并发症。我们报告２２９２例植入２５７５枚人工心脏瓣膜，发生瓣周漏者１３例，发生率为０．５１％（１３／２５７５）。外院术后瓣周漏转入我院者５例。１５例中再次手术，单纯修补５例，重新换瓣１０例。本组死亡５例。另３例瓣周漏因心功能尚好，暂未手术。

Periprosthetic Leakage Following Cardiac Valve Replacement:A Report with 18 Cases

Between May, 1976 and August,1991,2575 valves were replaced in 2292 patients.Periprosthetic leakage was found in 18 patients(including 5 performed at other hospitals)and occurred in prosthetic replacement of mitral valve in 11 cases and in aortic valve in 7. The incidence of this complication was 0.51%(13/2575).Reoperation for periprosthetic leakage was performed in 15 patients.Among these patients,5 had suture repair,and 10 had valve replacement.Hospital mortality from the reoperation was 33.3%(5/15).The predisposing factors of development of periprosthetic leakage include:(1)annular calcification or fragility;(2)annuloprosthetic disproportion;(3)excessive tension on sutures or annulus or both;(4)prosthetic infection;(5)inadequate suture material and size.