摘要
本文报道我所11例风湿性心脏瓣膜病合并巨大左房均在换瓣术同时施行左房折叠术,以改善巨大左房对左主支气管、肺及左室后壁的压迫,有科于术后心肺功能的恢复。本文讨论了巨大左房的诊断依据及左房折叠术的方法。
From December 1982 to June 1990 heart valvereplacement was performed on 206 patients in ourinstitute. 11 (5 males, 6 females, aged 23～42) of them were associated with big LA. Valve replacement together with folding of L.A was carried out. Heart function (NYHA) was class Ⅲ in 3 cases, class Ⅳ in 8 cases. C/T was 0.69-0.94 (mean 0.76). Among them 10cases had MVR with folding of LA, 1 case had DVR with folding of LA. Tricuspid DeVega anuloplasty was done in 3 cases. Low cardiac output syndrome appeared in 3 cases postoperatively, one of them died in the early postoperative period. Ventricular arrhythmia occurred in 2 cases. In 20-30 days postoperatively, routine examination showed that C/T decreased0.05-0.21 (mean 0.12), the internal diameter of LA decreased 20-40mm; heart function improved from class Ⅲ-Ⅳ to class Ⅰ-Ⅱ. Big left atrium pressed upon the left bronchus, lungs, esophagus, and posterior wall of L.A and worsened the heart and lung functions. Folding of LA could release the pressure, reduce postoperative complication oflungs and improve low cardiac output, avoid blood stasis caused by big LA, and prevent thrombogenesis.
出处
《中国循环杂志》
CSCD
1991年第4期279-280,共2页
Chinese Circulation Journal
