合并巨大左心室的心脏瓣膜替换术

Valve replacement in patients with giant left ventricle

目的:评价合并巨大左心室心脏瓣膜替换术的疗效。方法:从2000年9月至2002年10月,共13例合并巨大左心室的心脏瓣膜病行人工瓣膜替换术,其中主动脉瓣置换术9例,二尖瓣置换术1例,主动脉瓣置换术+二尖瓣置换术3例,二尖瓣置换术均保留二尖瓣后瓣及瓣下结构,三尖瓣成形术1例,左心房血栓清除术1例,主动脉窦瘤修补术2例,室间隔缺损修补术2例。结果:术后无死亡,无严重低心排、严重室性心律失常和多器官功能衰竭,并发肾功能不全1例,术后并发大量心包积液,行二次心包开窗引流术1例,13例均康复出院。结论:提高这类病人手术疗效的关键是选择合适的时机、妥善的围术期处理。

Objective: To evaluate the effectiveness of valvular replacement in patients with giant left ventricle (GLV). Methods: Valvular operations were performed in 13 patients (male 9, female4) with GLV between Sep 2000 and Oct2002. Aortic valve replacement in 9 patients, Mitral valve replacement in 1, Combined mitral and aortic valve replacement in 3, Mitral valve replacement all were with preserved mitral subvalvular structure, tricuspid valve annuloplasty in 1, repair of ruptured aneurysm of the sinus of Valsalva' s and ventricular septal defect in 2. Results: There were no perioperative mortality, no perioperative severe law cardiac output, severe ventricular arrhythmia and MOF. Conclusion: The keypoint to improve the results of these kind of patients are the choice of optimum surgical timing, the proper management of during perioperative.