冠脉旁路移植术与同期心脏瓣膜置换手术20例  

Combined coronary bypass grafting and cardiac valve replacement:report of 20 cases

作　　者：王蔚[1] 张开广[1] 王保毅[1] 侍巍[1] 缪丙荣[1] 张伟 

机构地区：[1]东南大学医学院附属徐州医院心血管外科,江苏徐州221009

出　　处：《现代医学》2009年第6期412-414,共3页Modern Medical Journal

摘　　要：目的总结同期实施冠脉旁路移植与心脏瓣膜置换手术的危险因素、治疗效果和临床经验。方法2006年1月至2009年4月我科同期实施冠脉旁路手术和心脏瓣膜置换手术20例,均于体外循环下实施。其中冠状动脉病变合并心脏瓣膜疾病12例,风湿性心脏瓣膜疾病合并冠状动脉疾病8例,合并左心房血栓2例。结果术后5例发生低心排,4例成功救治(其中3例予主动脉内球囊反搏支持),1例因多器官衰竭死亡;再次开胸止血1例。19例患者心脏功能明显改善,临床治愈出院;术后随访138个月,无死亡事件,患者生活质量明显改善。结论同期实施冠状动脉旁路手术和心脏瓣膜置换手术是可行有效的,手术近期效果令人满意。Objective To investigate the risk factors,the clinical experience and the early results of combined coronary bypass grafting （CABG） and cardiac valve replacement. Methods From Jan. 2006 to Apr. 2009, combined CABG and valve replacement were performed in 20 patients. Twelve patients were coronary artery disease with valvular dysfunction, and 8 patients were rheumatic heart disease with coronary stenosis,2 patients with left atrial thrombus. All patients were in the off-pump surgery. Results Five cases occurred postoperative low cardiac output,3 of them were given intra-aortic balloon pump support. One cases died due to multiple organ failure. One cases of re-thoraeotomy to stop bleeding. Nineteen cases cardiac function were significant improvement,who were followed up for 1 -38 months,no deaths was found. The quality of life of the patients were improved markly. Conclusion Combined CABG and valve replacement surgery is feasible and effective, short-term effect of satisfaction with the surgery.

关 键 词：冠心病 心脏瓣膜疾病 心脏瓣膜置换 冠状动脉旁路移植 

分 类 号：R654.1[医药卫生—外科学]