合并巨大左心室心脏瓣膜置换术的临床分析

Clinical analyses of cardiovalvular operations in patients with severe dilated left ventricle

目的分析合并巨大左心室心脏瓣膜置换术的外科治疗经验,提高瓣膜置换术的疗效。方法对2008年1月至2011年12月实施的67例合并巨大左心室心脏瓣膜置换术的临床资料进行回顾性分析。结果术后发生并发症34例(50.71%),死亡4例(5.97%)。低心排综合征和恶性心律失常及其所导致的多脏器功能衰竭是合并巨大左心室瓣膜置换术后的主要并发症和死因。结论巨大左心室是影响心脏瓣膜置换术的疗效的重要因素,充分的术前准备,术中良好的心肌保护,恰当的手术处理及严密的术后监护对提高提高巨大左心室心脏瓣膜置换术患者的疗效至关重要。

Objective To review our experience of operation for patients with valvular heart disease and giant left ventricle in order to improve the results of valve replacement operation. Methods Sixty-seven patients with giant left ventricle underwent valve replacement operation from January 2008 to December 2011 were analyzed retrospectively. Results There were 34 cases with early postoperative complications（50.71% ）, and 4 cases died. mortality was 5.97%. Malignant ventrieular arrhythmia and low cardiac output syndrome （LCOS） and multiple organal failure（MOF） were principal complications and obituary causes. Conclusion Gi- ant left ventricle is the key to the effect of valve replacement surgery. And full pre-operation, good myocardial protention, appropriate valve handle during the operation, and the intensive post-operation cares are all essential to successful valve replacement surgeries for patients with giant left ventricle.