再次心脏瓣膜置换术43例临床分析

Clinical analysis on re-do valve replacement of 43 cases

目的总结43例人工心脏瓣膜再次置换手术的治疗方法及体会。方法手术均经胸骨正中切口在体外循环下进行。其中行二尖瓣置换术（MVR）21例，主动脉瓣置换术（AVR）6例，二尖瓣置换加主动脉瓣置换术（DVR）10例，同期三尖瓣成形术（TVP）共23例，三尖瓣置换（TVR）6例。结果住院期间死亡1例，其余患者心功能明显改善，出院时心功能改善至I级36例、Ⅱ级7例。结论把握好手术时机，术中良好的心肌保护，再次心脏瓣膜置换术是安全可行的。

Objective To summarize the methods and effects of 43 cases of repeated cardiac valve re placement. Methods Midsternum incisions were made in all cases. 43 patients underwent repeated cardiac valve replacement under cardiopulmonarybypass. Mitral valve replacement was done in twentyone cases, mitral and aor tic valve replacement in ten cases, aortic valve replacement in six cases, tricuspid plasty in twentythree cases.tricuspid replacement in six cases. Results One died during hospitalization and the cardiac function of the survivors was improved significantly, thirty-six to grade I , and seven to grade lI. Conclusion Repeat cardiac valve surgery is safe and feasible if operation be performed in time, with good myocardial protection.