二尖瓣置换术后左心室破裂

Rupture of Left Ventricle Following Mitral Valve Replacement

目的 :总结分析二尖瓣置换术后左心室破裂的经验教训。 方法 :1 995年～ 2 0 0 1年间我院共有 9例二尖瓣置换术后发生左心室破裂的患者 ,占同期二尖瓣置换术的 0 2 3%。其中早期破裂 2例 ,延迟性破裂 7例。修补方法 :单纯心外缝合 1例 ,心内心外同时修补 7例 ,未行修补 1例。 结果 :死亡 6例 ;存活 3例 (平均随访 4年 ) ;其中 2例为左心室早期破裂 (术后 1小时内 ) ;1例为术后 2小时破裂。 结论 :快速建立体外循环是抢救左心室破裂的关键。

Objective:To summarize the experience in the treatment of left ventricular rupture following mitral valve repalcement. Methods:From 1995 to 2001,there were nine cases of left ventricular rupture(2 of early rupture and 7 delayed rupture),with the incidence of 0 23%.External repair alone was used in one,and external plus internal repair was used in 8. Results:Six patients died.The patients survived after a 4 year follow up,two with early rupture and one delayed rupture.Their NYHA functional classification was class Ⅱ in one and class Ⅲ in two. Conclusion:Rapid setting up of cardiopulmonary bypass is the key to the treatment of left ventricular rupture.