儿童瓣膜置换术

Prosthetic heart valve replacement in children

对11例4～14岁的瓣膜病变患儿进行儿童瓣膜置换术，其中4例合并有其他心脏畸形予以同期修复，无住院死亡。晚期死亡1例，存活者心功能Ⅰ～Ⅱ级。认为：小儿应首选机械瓣；抗凝治疗是术后的主要问题；对左侧位（主动脉瓣、二尖瓣）瓣膜术后应用小剂量抗凝剂在凝血酶原时间标准化比值监测下是安全的；儿童应尽可能选用符合成人需要型号的瓣膜。

Eleven children aged 4~14 years underwent prosthetic valve replacemet,4 patients required additional procedures. There was no hospital death. Followup from 3 monthes to 15 years, one late death (9. 1%) occurred. The remaining patients manifested improvement in their heart function class. The results suggest that mechanical prostheses have an excellent record of durability and is the 1st choice for children. Anticoagulation therapy is the major problem in these patients postoperatively. The greater type of mechanical valve is essential for valve replacement in children.