通讯作者：修宗谊,Email:13504909539@163.com

目的：提高再次人工心脏瓣膜置换患者的生存率及生活质量。方法：总结2006年5月～2014年5月中国医科大学附属第一医院心脏外科住院再次心脏瓣膜手术患者69例。置换二尖瓣瓣膜31个,修复17个；置换主动脉瓣15个,修复10个；三尖瓣置换3个。术前心功能分级( NYHA)II级22例,III级31例,IV级16例。结果：住院期间死亡5例,死亡率：7.24%(5/69)。术后随访49例(随访率:76.56%),随访时间7个月-8年；随访中再手术6例,死亡7例；存活患者42例,心功能：III级1例,II级12例,余心功能正常。结论：对瓣膜置换术后任何原因导致的重度瓣膜功能障碍,早期诊断、及时采取正确的手术方法将有利于提高患者的生存率。外科手术联合药物治疗是提高术后生存质量的关键。

Reoperation after Artificial Valve Prosthesis Replacement: An Analysis of 69 Cases

Objective: To improve the survival rate and the life quality of the patients who had undergone reoperation after artificial valve prosthesis replacement. Methods From May 2006 to May 2014, we performed reoperation on 69 patients. Among the patients, there were 31 cases of mitral valvular replacement, 17 cases of mitral valvular repairing, 15 cases of aortic valvular replacement, 10 cases of aortic valvular repairing, 3 cases of tricuspid valvular replacement. Before reoperation, the cardiac function( NYHA) of the patients was class II in 22 patients, class III in 31 patients, and class IV in 16 patients. Results There were 5 hospital deaths with a mortality of 7.24%( 5/69). Follow-up was done to 49 cases for 7 to 96 months, which showed 6 case reoperations and 7 cases late deaths. All other 42 cases recovered to NYHA class I to II. Conclusion The early diagnosis and timely reoperation of severe vavular dysfunction caused for any reason after artificial valve prosthesis replacement may improve the survival rate. And the keys to higher life quality is the combination of surgical operation and pharmacotherapy.