心脏跳动中二尖瓣置换术234例临床分析

Clinical analysis of 234 cases of mitral valve replacement in beating heart

目的 报告 2 34例浅低温体外循环心脏跳动中二尖瓣替换术经验 ,完善手术技术。方法 浅低温体外循环 (30～32℃ ) ,不阻断主动脉 ,不灌注心脏停搏液 ,保持心脏缓慢空跳进行二尖瓣替换术。结果 全组 2 34例病人均顺利完成手术 ,早期死亡 2例 ,手术死亡率 0 .85 %。结论 心脏不停跳二尖瓣置换术是一种安全可行的术式 ,可有效减轻心脏缺血再灌注损伤 ,值得进一步研究和推广应用。

Objective To introduce the technique of mitral valve replacements in beating heart, and review the clinical experience in 234 cases of operation. Methods A total of 234 patients of mitral valve replacement in beating heart with mild hypothermic extracorporeal circulation (30～ 32 ℃) were reviewed. Results The procedures underwent fluently and only 2(0.85%) died early postoperatively. No low cardiac output, arrhythmia and cerebral embolism complications was found. Conclusion Results suggested that mitral valve replacement in beating heart is a safe and available method and is good in extenuating myocardial and pulmonary injury from ischemia reperfusion and deep hypothermia.