50例老年心脏瓣膜病的外科治疗分析

Results of Surgical Treatment in Valve Disease in 50 Elderly Patients

目的总结老年心脏瓣膜病患者的外科治疗经验。方法对50例老年患者(60～72岁)施行瓣膜置换术,其中行二尖瓣置换(MVR)27例,二尖瓣及主动脉瓣置换(BVR)8例,主动脉瓣置换(AVR)15例,同时行三尖瓣成形术(TVP)30例,冠状动脉旁路移植术(CABG)4例。结果本组围手术期死亡4例;出院后随访1～48个月,心功能恢复至Ⅰ级18例,Ⅱ级30例,Ⅲ级2例。结论随着体外循环心肌保护技术的发展,手术技术和外科监护技术的成熟完善,加强围手术期的处理,老年瓣膜置换术是安全有效的。

Objective To summarize the experience of valvular surgery in the elderly. Method 50 elderly patients（age from 60 to 72 years） with cardiac valve disease were underwent valve replacement operation from Jan. 2000 to Oct. 2007, among which 27 cases were undergone mitral valve replacement（MVR）, 8 with combined mitral and aortic valve replacement（DVR）, and 15 with aortic valve replacement （AVR）. 30 cases also had simultaneous operation for tricuspid valvuloplasty（TVP）, and for coronary artery bypass graft （CABG）. Result There was 4 cases died in early surgery. All other patients were followed-up from 1 to 48 months. 18 cases were restored to New York Heart Association （NYHA） class Ⅰ function, 30 to class Ⅱ , and 2 to class Ⅲ. Conclusion With the advancement of myocardial protection, the perfection of surgical technology and surgical monitoring technology, to enhance perioperative management, surgical treatment in valve disease is an effective and safety theranv in the elderlv.