702例心脏瓣膜置换术及其主要并发症的临床分析

Analysis of complications after cardiac valve replacement: report of 702 patients

目的 探讨影响或导致心脏瓣膜置换术围手术期死亡及主要并发症的相关因素。方法 对 70 2例心脏瓣膜置换术患者的临床资料进行回顾性分析。 结果 本组患者围手术期死亡及主要并发症的发生与术前心功能Ⅲ～Ⅳ级 ,心胸比≥ 0 70 ,左心室舒张末内径≥ 70mm ,术中心脏阻断时间过长及体外循环时间过长 ,术中心肌保护不满意等有关。 结论 心脏瓣膜置换术患者围手术期死亡及主要并发症的发生与术前心功能、术中心肌保护。

Objective To define the determinants of perioperative death and complications after cardiac valve replacement in 702 patients. Methods Clinical data of the patients after cardiac valve replacement were analyzed retrospectively. Results Perioperative mortality and morbidity correlated significantly with some of the perioperative variables, such as higher NYHA functional class (ⅢorⅣ), large left ventricular end diastolic diameter (≥70 mm), C/T≥0 70, prolonged aortic cross clamping time and cardiopulmonary bypass time, unsatisfactory myocardial protection. Conclusions Perioperative mortality and morbidity correlate significantly with some of perioperative variables, such as higher NYHA functional class, unsatisfactory myocardial protection, inappropriate surgical procedure, improper therapy of some complications after cardiac valve replacement. To avoid the occurrence of these independent predictors or to correct them timely might effectively decrease the perioperative mortality and morbidity after cardiac valve replacement.