摘要
目的：随着心脏手术的广泛开展,需要再次进行瓣膜替换的手术日趋增多。文中总结72例心脏再次二尖瓣瓣膜替换术的治疗经验。方法：自1995年1月至2007年12月共72例行心脏手术患者再次手术替换二尖瓣,再次瓣膜手术距第1次手术1~21年,平均（13.7±6.7）年。同期行左心房血栓清除13例,三尖瓣成形39例。全组均采用中低温体外循环冷晶体停跳、温血停博液持续灌注的心肌保护方法。结果：手术早期死亡2例,病死率2.8%,其余随访期间无死亡,心功能均得到明显改善。结论：再次行二尖瓣瓣膜替换术安全可行,术中应加强心肌保护,积极处理三尖瓣返流,并尽可能采用三尖瓣环成形术。
Objective： With more and more cardiac surgery performed,repeat heart valve operations have become a quite common procedure.This article sums up the experience of mitral valve replacement in repeat cardiac surgery for 72 patients.Methods： Seventy-two patients underwent repeat cardiac surgery for mitral valve replacement from 1995 to 2007.The interval between the two procedures was 1 to 21（13.7 ± 6.7） years.The associated procedures included atrial thrombosis elimination（n=13） and tricuspid valve repair（n=39）.Hypothermic cardiopulmonary bypass combined with warm blood retrograde perfusion was performed for the protection of the heart in all the patients.Results： The early postoperative mortality was 2.8%（2 / 72）.No other patients died during the follow-up period and the cardiac function of the survivors was significantly improved.Conclusion： Repeat cardiac surgery for mitral valve replacement is safe and feasible.During the procedure,stress should be given to cardiac protection and management of tricuspid regurgitation by tricuspid valvoplasty.
出处
《医学研究生学报》
CAS
2009年第12期1284-1286,共3页
Journal of Medical Postgraduates
基金
南京军区南京总医院科研基金资助项目(批准号:2006044)
关键词
人工心脏瓣膜置入
二尖瓣
再次手术
Heart valve prosthesis implantation Mitral valve Reoperation
