二尖瓣置换术后左心室破裂7例分析  

Analysis of seven cases with left ventricular rupture after mitral valve replacement

作　　者：薛东明[1] 王伟林[1] 陆源建[1] 赵田[1] 

机构地区：[1]徐州市第一人民医院心胸外科,江苏省221002

出　　处：《江苏医药》2014年第1期61-63,共3页Jiangsu Medical Journal

摘　　要：目的探讨二尖瓣置换术后左心室破裂的易发因素及防治策略。方法回顾性分析7例行二尖瓣置换术后发生左心室破裂的诊治经验。结果二尖瓣置换术后发生左心室破裂7例。早期破裂6例,延迟破裂1例;Ⅰ型破裂3例,Ⅱ型破裂2例,Ⅲ破裂2例。手术抢救成功3例,死亡4例。结论二尖瓣置换术后左心室破裂原因复杂,绝大多数与医源性因素有关。明确左心室破裂后应立即重建体外循环、心脏停搏、拆除人工瓣膜、心内心包补片覆盖修补。Objective To analyze seven cases with left ventricular rupture after mitral valve replacement. Methods The experiences in treating left ventricular rupture after mitral valve replacement were summerized by retrospectively analyzing clinical data of 7 cases. Results Left ventricular rupture after mitral valve replacement took place in 7 patients, of whom, typy I rupture occurred in 3 cases, type Ⅱ in 2 cases, and type Ⅲ in 2 cases. Six cases were with early rupture and one case was with delayed rupture. Three patients survived and four patients died with a mortality of 57.1%. Conclusion The causes of left ventricular rupture after mitral valve replacement are complex and mainly related to iatrogenic factors. To immediately reconstruct cardiopulmonary bypass and cardiac arrest, remove prosthetic valves, and suture endocardium with covering pericardial patch should be taken as long as the left ventricular rupture is confirmed.

关 键 词：二尖瓣置换术 左心室破裂 

分 类 号：R654[医药卫生—外科学]