107例双瓣置换手术临床分析

Perioperative management of 107 cases with heart double valve replacement

目的:回顾分析107例双瓣置换手术围手术期资料,探讨双瓣置换的围手术期临床特点。方法:手术在体外循环,中度低温情况下进行,其中保留二尖瓣及瓣下结构98例,左房折叠10例,二尖瓣成形82例,同时行冠脉旁路移植术(CABG)5例。结果:105例患者康复出院,死亡2例,死因分别是低心排综合症及恶性心律失常。结论:双瓣膜置换是治疗瓣膜病变的有效手段,适当的手术时机,不断改进和提高体外循环技术,手术技巧,尽量保留瓣下结构,可降低手术风险,提高疗效。

Objective： To review the experience of 107 cases with heart valve replacement from 2000 to 2007. Methods： All 107 cases were underwent heart valve replacement under hypothermia and cardiopulmonary bypass （CPB）, 98 cases underwent redo-valve replacement, 5 patients simultaneously received associated CABG for the serious coronary disease. Results： The 105 cases recovered and discharged. There were two cases death; the major causes of early death were ventricular arrhythmia, circulatory failure. Conclusion： Double valve replacement is an effective remedy for valve disease; correct perioperative management can significantly decreased operative complication and mortality rate.