严重钙化性主动脉瓣病变的手术策略及治疗效果观察

Observation on effect of surgical therapy of serious calcified aortic valve disease:Analysis of 13 cases

目的探讨严重钙化性主动脉瓣病变手术治疗效果。方法对13例严重钙化性主动脉瓣病变患者行手术治疗,其中同时行二尖瓣置换术3例,冠状动脉旁路移植术1例,升主动脉成形术2例,Bentall术1例,三尖瓣成形术2例。结果围手术期死亡3例,1例术后出现Ⅲ°房室传导阻滞,其余术后均顺利恢复,无其他严重并发症。结论严重钙化的主动脉瓣病变手术死亡率高,术中应加强心肌保护,对钙化部分合理处理,能有效防止并发症,降低手术死亡率。

Objective To discuss the effect of surgical therapy of serious calcified aortic valve disease. Methods Thirteen cases of serious aortic valve disease underwent surgical treatments including 3 cases of mitral valve replacement, 1 case of coronary artery bypass grafting,2 cases of aortoplasty, 1 case of Bentall and 2 cases of tricuspid valvuloplasty. Results Perioperative death occurred in 3 cases. One patient had Ⅲ° atrial ventricular block after surgery. The others recovered well after operation without any serious complication. Conclusions Serious calcified aortic valve disease has a high operative mortality. We should enhance the protection of myocardi- um during operation and appropriately manage calcified tissues to prevent complications and reduce operative mortality.