浅低温不停跳重症瓣膜置换13例临床分析

Analysis of heart surgery with mild hypothermic and beating heart in treatment of value replacement with value heart disease of high risk in 13 cases

目的 分析浅低温心脏不停跳重症瓣膜置换术的临床效果。方法 浅低温不停跳下为 13例重症瓣膜病人实施瓣膜置换术 ,其中二尖瓣置换 8例 ,主动脉瓣置换 2例 ,双瓣置换 3例。 5例保留二尖瓣装置 ,7例同时行三尖瓣成形 ,5例左房血栓者同时行血栓清除术。结果 全组患者无手术中死亡 ,仅 1例术后 4 8小时死于严重心律失常 ,其余病人心功能恢复良好。结论 重症瓣膜病人浅低温不停跳下换瓣 ,有利于心肌保护 ,减少术后并发症的发生 ,效果令人满意。

Objective: To evaluate the effect of open heart surgery with mild hypothermic and beating heart in the treatment for value replacement on value heart disease of high risk. Methods: The technique of open heart surgery with mild hypothermic and beating heart was used in 13 patients with value heart disease of high risk. MVR was performed in 8 case of them, AVR in 2 and DVR in 3 cases. Mitral apparatus remained in 5 cases, TVP was performed in 7 cases, and simultaneously thrombus of left artria were cleaned out in 5 cases. Results: No one died during operation, only one patient died of serious arrhythmia in 48 hours after the operation, and the other patients restored their heart functions effectively. Conclusion: The value replacement with mild hypothermic and beating heart is preferable for the patients with high risk in myocardial protection and in reducing postoperative complications, and the effect is satisfactory.