较复杂心脏手术53例无死亡的经验

EXPERIENCE OF COMPLICATED HEART SURGERY IN 53 CASES WITHOUT DEATH

本文报告了瓣膜置换、法乐氏四联征根治术等较复杂心脏手术53例,无一例死亡,文中对手术时机选择、术中心肌保护和术后心功能支持进行了讨论。

From Dec. 1982 to April 1988. 150 open heart operation were performed in our hospital. Among these patients, 53 complicated heart operation were done without early and late operative death. 26 of 53 were congenital cardiac anomalies. 11 for Fallot's tetralogy and Fallot's pentalogy (F_4 and F_5), 3 for Fallot's trilogy (F_3), 4 for VSD with pulmonary hypertension, 3 for ASD with anomalous pulmonary drainage, 2 for Lutembacher's syndrome, 3 for triatriatum, Ebstein's anomaly and double outlet right ventricle. 26 of 53 were rheumatic heart disease. 20 for mitral valve replacement, 2 for aortic valve replacement, 2 for double valve replacement, 2 for mitral valve reconstructive surgery. 1 of 53 was heart tumour(left atrial myxoma). In the article, the authors pointed out that the excellent operative results obtained are closely related to: (1) key of the success are the selection of time and method for operation, (2) effective myocardial protection——improvement of perfusion technique, (3) post-operative circulatory support——combined use of vasodilator and dopamine.