心脏瓣膜替换术的应用

自1979年10月至1984年12月共为53例病人施行54个人工瓣膜替换术。其中50例二尖瓣替换,1例主动脉瓣替换,1例主动脉瓣及二尖瓣替换,1例三尖瓣替换及二尖瓣成形术。术前心功能:Ⅱ级者6例(11%),Ⅲ级者35例(66%),Ⅳ级者12例(22%)。本组术后30天内死亡2例,死亡率3.7%。随访时间3个月至62个月,晚期死亡4例,死亡率为3.3%病人年。术后心功能明显改善。本文对术前准备,心肌保护及并发症作了讨论。作者认为:人工瓣膜至今尚未达到理想程度,对瓣膜替换术的病例选择应严格掌握。

CLINICAL USE OF HEART VALVE REPLACEMENT

During the period of 1979-1984, 53 patients received heart valve replacement ( 54 cases of valve replacement). There were 50 cases of mitral valve replacement, 1 cases of aortic valve replacement, 1 case of aortic valve and mitral valve replacement, 1 case of tricuspid valve replacement with valve plasty of mitral valve. Preoperative heart funetion of Class Ⅱ was seen in 6 patients(11%), Class Ⅲ in 35(66%)and Class Ⅵ in 12(22%). The early mortality was 2/53(3.7%)and the late mortality 3.3% patient year(4 cases). The postoperative heart function was improved well. As the heart valve prostheses are still unsatisfactory and after operation anticoagulants should be given and the thromboembolion rate is higher, the patient for surgery should be strictly selected.