据灌注情况决定主动脉瓣置换与否的中期效果

Mid-term result of aortic valve replacement or not decided by cardiac arrest after the cardioplegic solution perfusion from aortic root

目的分析用主动脉根部灌注心脏停搏液能否让心脏停跳来决定是否行主动脉瓣置换的方法的中期效果。方法选取我院2004年5月～2008年4月二尖瓣中度以上狭窄伴主动脉瓣轻度返流患者,在术中根据主动脉根部灌注心脏停搏液能否使心脏停跳来决定是否作主动脉瓣置换,收集到心脏停跳未行主动脉瓣置换患者共54例,同期收集术前不合并主动脉瓣返流直接行二尖瓣置换患者49例,随访两组患者左室舒末直径、心功能、射血分数、二次手术率等指标。结果两组患者的术前条件差异无统计学意义(P>0.05),随访(4.86±0.92)年,随访时间差异无统计学意义(P>0.05),两组患者术后左室舒末直径、升主动脉直径、心功能、射血分数和再次手术行主动脉瓣置换率等各项指标差异均无统计学意义(P>0.05)。结论对于术前主动脉瓣轻度返流的患者,如果主动脉根部灌注心脏停搏液能够使心脏停跳,可以不行主动脉瓣置换。

Objective To analysis the mid-term result of aortic valve replacement（AVR） or not decided Jby cardiac arrest after the cardioplegie solution perfusion from aortic root. Methods During May 2004 to Apt 2008,54 patients , diagnosed as middle or severe mitral stenosis（MS） with mild aortic regurgitation（ AR）, underwent mitral valve replacement（MVR） without AVR because of cardiac arrest after the eardioplegie solution perfusion from aortic root, and 49 patients, diagnosed as middle or severe MS without AR, underwent MVR. We followed up and compared the left ventricle diameter（ LVD）, heart function（ NYHA）, ejection fraction （EF）, re-operation ratio and so on. Results Followed up （4. 86 ± 0. 92） years, there is no statistical difference between the 2 groups in any data before or after the operation （P 〉 0. 05 ）. Conclusion If cardiac arrest after the eardioplegie solu- tion perfusion from aortic root,it＇s no need to do AVR.