再次瓣膜手术36例临床分析

Clinical analysis on repeated valve replacement of 36 cases

目的总结36例人工心脏瓣膜再次置换手术的治疗方法及体会。方法 36例病人接受了再次心脏瓣膜置换手术。手术均在体外循环下进行,心脏停搏20例,心脏不停搏16例;其中二尖瓣置换21例,主动脉瓣置换10例,双瓣膜和三瓣膜置换5例。结果手术早期死亡4例,随访存活病人心功能明显改善。结论再次换瓣手术应恰当掌握手术时机,可应用传统的心脏停搏法及不停搏法,手术疗效确切。

Objective To study the methods and effects of 36 cases of second time cardiac valve replacement. Methods 36 patents underwent repeated cardiac valve replacement under eardiopulmonary bypass, with 20 on arresting heart, 16 on beating heart. Of all patients,21 accepted mitral valve replacement, and 10 aort＇c valve replacement, and 5 double and trieuspid valve replacement. Results 4 patients died in early postoperative, the heart function of the survival patient were obviously improved. Conclusion Repeated valve replacement surgery should be carried on optimal operation time. Both conventional arresting heart and beating heart are of great effectiveness and safety to the reoperation for valve replacement.