177例双瓣替换术的心肌保护和辅助循环的探讨

The Experience of Myocardium Protection and Assistant Circulation for 177 Cases Undervent Double Valve Replacement

目的:本文报告了177例双瓣替换术的心肌保护和辅助循环方法。临床资料:本组病例包括165例主动脉和二尖瓣替换术,8例同时行三尖瓣成形术;4例同时行冠状动脉搭桥术。术前心功能Ⅲ-Ⅳ级,心胸比率54-89％。结果:升主动脉阻断时间48-265分。自动复跳114例,9例作IABP辅助,IABP时间6-162小时,7例成活,成功率为78％,全组177例住院死亡6例,占死亡3.40％。结论:在体外循环中采用综合的心肌保护和辅助循环的方法是手术成功的关键。

Objective; To conclude the experience of myocardiac protection and assiatant circulation for 177 cases underuent double Valve replacement,Method:From 1995 to 1997,177 cases,including 165 cases of aortic and mitral valve replacement 8 cases doudble Valve replacement with tricuspid valve replastic,4 cases with CABG. The preoperative heart funtion were I to IV NYSC,and cardiac Thoracic ratio were 54% to 89%. Results; The Aortic arrest time from 48 to 265 min. There were 114 cases had audo-resucitation,9cases underwent IABP. Tiom for IABP were from 6 to 162 min,7 cases were survive(78%), Hospital motality was 3. 40%. Conclusion: The Key for the success of operation is good myocardic protection and assistant circulation in extra-corporeal circulation.