瓣膜置换术伴发瓣膜周围漏的转归

The Outcome of Paravalvular Leakage

目的评估二尖瓣置换术和主动脉瓣置换术所伴发的瓣膜周围漏的转归。方法选择二尖瓣和(或)主动脉瓣置换术442例患者,其中53例患者术中发现瓣膜周围漏,记录与瓣膜周围漏相关的术后并发症和瓣膜周围漏的术后转归。统计学分析采用卡方检验。结果瓣膜周围漏患者术后ICU、住院时间延长,低心排综合征、房颤和脓毒血症等并发症显著增加。轻微瓣膜周围漏患者有良性转归,多数于术后1周消失;中、重度瓣膜周围漏需要术中进行修补。结论瓣膜周围漏为瓣膜置换手术的常见并发症,轻微瓣膜周围漏无需手术治疗,多数预后良好;而中度以上瓣膜周围漏,应于术中进行修补。

Objective To assess the outcome of perivalvular leakake（PVL） during procedures of mitral and/or aortic replacement. Methods After approved by the ethic committee of the hospital and obtaining written informed consent, we studied 442 cases of mitral and/or aortic valve replacement, collected relative complications. All data were analyzed with Chi Square. Results PVL group had a higher incidence of Low Cardiac Output Syndrome, atrial fibrillation and sepsis（9, 43 % vs2.31% ） and also longer stay in ICU and hospital. Most trivial and mild PVL disappeared in a year. PVL more than moderate had to be repaired intraoperatively. Conclusions PVL less than mild can disappear within one year, however those more than moderate had to be repaired intraoperatively.