二尖瓣位置入GK双叶瓣应用体会——附684例早期临床分析  

The early outcomes of 684 mitral valve replacement with GK mechanical prosthesis

作　　者：文仁国[1] 陈林[1] 肖颖彬[1] 王学锋[1] 陈柏成[1] 陈进劲[1] 郝嘉[1] 程伟[1] 马瑞彦[1] 

机构地区：[1]第三军医大学新桥医院心外科,重庆400037

出　　处：《心肺血管病杂志》2014年第1期10-12,共3页Journal of Cardiovascular and Pulmonary Diseases

摘　　要：目的:评估二尖瓣置换术中应用GK瓣的早期疗效。方法:回顾分析2007年1月至2013年6月间,二尖瓣位应用GK瓣的684例患者的临床资料:男性256例,女性428例,年龄(46.70±13.54)岁,病程(13.17±8.29)年;术前心功能分级(NYHA):II级141例,III级369例,IV级174例,其中,再次手术41例,感染性心内膜炎53例,急诊手术75例,合并心房颤动509例。结果:死亡7例,病死率1.02%。早期并发症为:严重低心输出量综合征(低心排)30例,转化为多脏器功能衰竭6例;恶性心律失常11例;呼吸衰竭12例;肾功能严重损害6例。随访6个月至3年,恢复良好,6个月时心脏超声检查心脏功能和二尖瓣跨瓣压差满意。出院1个月后,发生瓣膜血栓1例,该患者合并三尖瓣置换,再次手术见人工三尖瓣和二尖瓣均有血栓,再次置入GK瓣,术后恢复较好;出院后4个月发生瓣周漏1例,再次换瓣手术,恢复好。结论:二尖瓣位应用GK瓣安全,缝合环柔软,入座自然,早期疗效好。Objective：To evaluate the early outcomes of mitrial valve replacement with GK mechanical prosthesis.Methods：From Jan.2007 to Jun.2013,684 patients have undergone isolated mitral valve replacement with a GK mechanical prosthesis.The mean patient age was （46.70 ± 13.54） years and the mean course of disease was （13.17 ± 8.29） years.543 of 684 patients were in New York Heart Association （NYHA） functional class Ⅲ or Ⅳ.509 patients were combined with atrial fibrillation.41 patients were re-operation.There were 53 cases suffered from effective endocarditis and 75 cases underwent emergency operation.Results：There were 7 early deaths （1.02％）.Of 684 patients,30 suffered from low cardiac output syndromes,6 multiple organ failure,11 malignant ventricular arrhythmia,12 respiratory failure and 6 kidney failure.677 patients were discharged from hospital and all of them were undergone follow-up from 6 months to 3 years.All survivors were in NYHA functional class Ⅰ or Ⅱ at their last follow-up.The mean trans-valvular gradient of mitrial valve is less than 9 mmHg during follow-up.1 patients suffered from anticoagulant thrombus both at mitrial and tricuspid valve 1 month after discharge and recovered after re-operation.1 patient suffered from peri-valvular leakage 4 months later,and recovered after re-operation too.Conclusion：The GK mechanical prosthesis implantation is safe and effective for mitrial disease.

关 键 词：GK双叶瓣 瓣膜置换术 二尖瓣 

分 类 号：R543[医药卫生—心血管疾病]