浅低温心脏不停跳重症瓣膜病换瓣21例分析

Analysis of Heart Surgery with Mild Hypothermica and Beating Heart in Treatment of Valve Replacement with Valve Heart Disease of High Risk in 21 Cases

目的 :分析浅低温心脏不停跳重症瓣膜病换瓣的临床效果。方法 :为 2 1例重症瓣膜病患者在浅低温心脏不停跳下施行换瓣术 ,其中二尖瓣置换 2 0例 ,三尖瓣置换 1例。 9例为重危患者 ,12例保留二尖瓣装置 ,18例同时行三尖瓣成形。结果 :全组患者无手术死亡 ,无严重低心排及心律失常。结论 :浅低温心脏不停跳下施行换瓣术 ,有利于心肌保护 ,结合围术期的心功能维护 ,术中正确处理瓣膜病变 ,重症瓣膜病换瓣的效果令人满意。

Objective: To evaluate the effect of open heart surgery with mild hypothermica and beating heart in treatment of valve replacement with valve heart disease of high risk. Methods: The technique of open heart surgery with mild hypothermica and beating heart was used on 21 patients with valve heart disease of high risk. 19 of them were cases of rheumatic heart disease and 2 were Marfan Syndrome with mitral incompetence. Mitral valve replacement was performed in 20 patients. Tricupid valve replacement was performed in 1 patient. Results: No low cardiac output or severe arrhythmia were found.No patients died within 30 days of operation. Conclusion: This new technique is more beneficial in myocardial protection. Moreover, proper surgical intervention and perioperative management is also one of the important factors influencing surgical outcome of valve heart disease of high risk.