摘要
目的 总结在二尖瓣置换术中保留后瓣及瓣下结构的临床效果.方法 回顾分析我院72例行保留二尖瓣后瓣及瓣下结构二尖瓣置换术的临床资料.患者平均年龄51岁,病程2-18年,平均11.3年.全身麻醉体外循环下行手术治疗,单纯二尖瓣置换15例,二尖瓣瓣置换同时行三尖瓣Deve,成形术45例,二尖瓣置换同时行主动脉瓣置换12例,术后呼吸机辅助呼吸时间5-15（6.8±1.4）h,ICU停留时间2-5（2.6±0.4）d.结果 全组无死亡病例,术后3例出现肺部感染,2例出现恶性心律失常,均治愈,其他无相关并发症发生,均治愈出院.63例术后3-8个月复查超声心动图示左室射血分数0.56-0.68（0.59±0.05）,LVEDD 43-62 （46.0±3.6）mm;X线示心胸比率0.45～0.70（0.51±0.03）.出院后通过门诊随访和电话随访,无远期死亡,无抗凝相关并发症.结论 保留二尖瓣及瓣下结构的二尖瓣置换术有利于术后左心室功能的恢复,减少了术后并发症的发生.取得了良好的临床效果.
Objective To summarize our experience and the clinical outcomes of preservation of the mi- tral subvalvular apparatus in mitral replacement. Methods The seventy-two patients cases which were performed mitral valve replacement through preservation of the mitral subvalvular apparatus were analyzed. The average age of the patients were fifty-one years old. The course of disease were 2-18 years, the average were 11.3 years. The operations were undertook under the cardiopttlmonary bypass of general anaesthesia. The simple mitral valve re- placement were 15 cases. The mitral replacement and Devega plasty were 45 cases. The mitral valve replacement and the aortic valve replacement were 12 cases. The assisted respiration time of postoperative were 5-15 hours, average （6.8±1.4）hours.The time in ICU were 2-5 days, average （2.6±0.4）days. Results The morbidity were zero, three cases were lung complication, two cases were ventricular arrhythmias. All were recovery. There was no other complication in the follow-up through the telephone and in the outpatient department. The left ventricle ejection fraction in sixty-three cases were 0.56-0.68 after 3-8 months of postopreation, average （0.59±0.05）. LVEDD 43-62 mm,average（46.0±3.6）min. The cardio-thoracic ration were 0.45-0.70, average （0.51±0.03）. Conclusion The preservation of mitral subvalvular apparatus is benefit to improve the left ventricular functions; it can reduces the complication of postoperative and the clinic effective is better.
出处
《中国心血管病研究》
CAS
2011年第2期141-143,共3页
Chinese Journal of Cardiovascular Research
关键词
二尖瓣置换术
保留瓣下结构
并发症
Mitral valve replacement
Subvalvular apparatus
Complication
