主动脉瓣置换术后早、中期左室功能随访  

The regression of left ventricular dilatation and hypertrophy in early and intermediate stage after aortic valve replacement

作　　者：周建仓[1] 王永清[1] 徐勇[1] 朱鉴清[1] 郦志军[1] 何启才[1] 郭继革[1] 

机构地区：[1]浙江大学医学院附属邵逸夫医院心胸外科,杭州310016

出　　处：《浙江医学》2004年第6期420-423,共4页Zhejiang Medical Journal

摘　　要：目的观察主动脉瓣置换术后早、中期左心室功能的恢复情况。方法回顾分析1997年1月～2002年12月我院施行单独主动脉瓣置换术后随访资料齐全的51例患者的超声心动图资料。结果术后早期左室舒张末内径(LVEDD)及收缩末内径LVESD明显减小,分别由术前(62.1±12.6mm及41.9±11.7mm)回缩到(46.9±7.6mm及29.0±7.0mm),接近正常水平,差别有显著性意义(P<0.001)。左室射血分数(LVEF)术前为(59.2±13.7)%,术后早期及中期分别为70.3±8.5%及68.8±10.8%,与术前比较差别均有显著性意义(P<0.01)。按患者术前LVEF分为正常(LVEF≥50%)组和减低(LVEF<50%)组,术后两组间表现出明显差异:LVEF正常组恢复明显好于减低组。按患者术前LVEDD分为巨大左室组(LVEDD≥70mm)和非巨大左室组(LVEDD<70mm),术后两组间也表现出明显差异:术前非巨大左室组术后左室内径及LVEF恢复明显好于巨大组。结论主动脉瓣置换术能明显改善术前受损的左心功能,术前LVEF及LVEDD是影响术后左心恢复的重要因素之一,并可据此判断预后。Objective To assess the early and intermediate regression of left ventricular dilatation and hypertrophy in aortic valve diseases after aortic valve replacement. Methods fifty-one consecutive patients undergoing isolated aortic valve replacement from Jan.1997 through Dec.2002 were analyzed retrospectively with echocardiogram. Results Preoperatively the left ventricular end diastolic diameter (LVEDD) and end systolic diameter (LVESD) were much larger than those of control group (P<0.001). LVEDD and LVESD decreased dramatically in early stage after operation [from (62.1±12.6)mm and (41.9±11.7)mm to (46.9±7.6)mm and (29.0±7.0)mm respectively, P<0.001], returned to normal range. Ejection fraction of left ventricle (LVEF) increased significant both in early and intermediate stage after operation [(70.3±8.5)% and (68.8±10.8)% vs preoperative (59.2±13.7)%, P<0.01]. The recovery was more satisfactory for group with a preoperative LVEF≥50% of the normal LVEF than that of LVEF<50% group. The reduction of LVEDD and increase of LVEF in preoperative LVEDD<70mm group was more significant than those of LVEDD≥70mm group. Conclusion The left ventricular function in aortic diseases can be greatly improved after aortic valve replacement. Preoperative LVEF and LVEDD are two key factors for predicting the results after aortic valve replacement.

关 键 词：主动脉瓣置换术 早期 中期 左室功能 随访 超声心动图 主动脉瓣狭窄 主动脉瓣关闭不全 

分 类 号：R654.2[医药卫生—外科学]