二尖瓣替换术后9例左室破裂

Rupture of Left Ventricle after Mitral Valve Replacements.A Report of 9 Cases

二尖瓣替换术后左室破裂属少见而死亡率极高的并发症。阜外医院自１９７６年５月至１９９１年１０月行二尖瓣替换（ＭＶＲ）或合并其它手术共２０７５例，其中左室破裂９例，发生率为０．４３％（９／２０７５）；抢救成功３例。预防措施包括：（１）避免心脏受到各种机械性损伤；（２）保留左室生理结构环的完整性；（３）术中、术后早期心肌保护措施得当。

Rupture of left venticle after mitral valve replacement is a rare but life threatening complication.From May, 1976 through October, 1991, 2075 mitral valve replacements(isolated or combined with other procedures)were performed at Fuwai Hospital of CAMS, Beijing.Rupture of the posterior wall of the left ventricle was observed in 9 patients. Only 3 of them survived after the emergency surgical repair.The incidence of the left ventricular rupture was 0.43% (9/2075).This complication may be prevented by leaving the posterior mitral leaflet and its attached chordae tendonae intact,avoiding excessive surgicl trauma and using satisfactory myocardil protection during and early after operation.