巨大左室心脏瓣膜病外科治疗体会  

Surgical Treatment Patients with Cardiac Valve Disease of Giant Left Ventricle

作　　者：赵龙[1] 朱宪明[1] 刘志平[1] 高荣[1] 张玉龙[1] 邱能庸[1] 

机构地区：[1]内蒙古医学院附属医院胸心外科,内蒙古呼和浩特010050

出　　处：《疾病监测与控制》2011年第3期156-157,共2页Journal of Diseases Monitor and Control

摘　　要：目的总结巨大左心室行心脏瓣膜置换术的临床资料和治疗效果,探讨手术适应证选择、术中心肌保护和围术期的处理方法。方法 2001年5月至2010年8月共为68例瓣膜病合并巨大左心室病人施行了心脏瓣膜置换术,其中双瓣膜替换术(MVR+AVR)42例,主动脉瓣替换术(AVR)17例,二尖瓣置换术(MVR)9例,同期行三尖瓣成形术33例,左房折叠术20例,同期行冠状动脉旁路移植术7例。结果术后早期并发症31例次(45.5%)。早期死亡10例(占6.8%),主要为低心输出量综合征、室颤和重要脏器功能衰竭。结论选择合适手术时机,术前充分准备、术中加强心肌保护以及术后早发现和早处理并发症,可提高此类病人手术疗效。Objective To summarize the experience of surgical treatment of cardiac valve disease with giant left ventricle for the operative indication, myocardial protection,and management during perioperative period.Methods 68 patients with cardiac valve disease of giant left ventricle underwent valve replacement from May 2001 to August 2010.Combined mitral and aortic valves replacements were performed in 42 cases.Aortic valve replacement in 17 cases. Mitral valve replacement in 9 cases.Concomitantly,tricuspid valve annuloplasty,left atrium placation,and coronary artery bypass grafting were applied in 33,20,7 respectively.Results The early postoperative complication and mortality rate were 45.5%and 6.8%respectively.Ventricular arrhythmia,low cardiac output syndrome and multiple system organ failure were the main causes of the early death.Conclusion Appropriately operative timing,intensive myocardial protection during surgery and perioperative management are crucial and necessary to surgical treatment of cardiac valve disease with giant left ventricle.

关 键 词：心脏瓣膜疾病 心脏瓣膜假体植入 心室功能障碍 

分 类 号：R[医药卫生]