老年心脏瓣膜病变152例外科治疗体会.doc

老年心脏瓣膜病变152例外科治疗体会
作者:陈凯明,陈海生,钟焕清,黄志辉,钟志敏,陈景伟作者单位:高州市人民医院心外科,广东高州 525200
【摘要】目的总结老年心脏瓣膜病变的外科治疗经验。方法回顾性分析152例老年心脏瓣膜病变外科治疗患者的临床资料。行二尖瓣置换(MVR)77例,主动脉瓣置换(AVR)39例,双瓣置换36例;同期行三尖瓣成形术92例,冠状动脉搭桥术19例,左房折叠术4例。结果手术早期死亡6例,%。随访140例,随访时间6个月至8年,死亡2例,其余138例术后随诊复查人工瓣膜功能良好,左心室射血分数(LVEF)提高,心功能均提高1~2级,无瓣周漏、人工瓣膜心内膜炎及心脏血栓形成,没有因瓣膜原因而再次手术者。结论术前充分调整心功能,选择适当的手术时机,加强术中心肌保护,不断改进和提高手术技巧,加强围术期管理,是提高老年心脏瓣膜病变患者手术成功率的关键因素。
【关键词】心脏瓣膜病;心脏瓣膜置换术;老年人
Analysis of 152 cases of surgical therapy of heart valve disease in aged patients
CHEN Kaiming, CHEN Haisheng, ZHONG Huanqing, HUANG Zhihui, ZHONG Zhimin, CHEN Jingwei
(Department of Cardiac Surgery, Gaozhou People′s Hospital, Gaozhou, Guangdong 525200, China)
Abstract: Objective To summarize the experience of surgical therapy of heart valve disease in aged patients. Methods Clinical data of 152 cases of surgical therapy of heart valve disease in aged patients from Jan. 2000 to Dec. 2007 were retrospectively analyzed, including 77 cases of mitral valve replacement, 39 of aortic valve replacement and 36 of double valve replacement. Meanwhile, 92 cases of tricuspid valvuloplasty, 19 of coronary artery bypass graft and 4 of left atrial wall plication were performed. Results There were 6 deaths shortly after operation (mortality of %). Follow-up ranging from 6 months to 8 years to 140 cases revealed that 138 cases except 2 deaths had good heart valve