中华胸心血管外科杂志
中華胸心血管外科雜誌
중화흉심혈관외과잡지
Chinese Journal of Thoracic and Cardiovascular Surgery
2009年
1期
11-13
,共3页
崔永超%来永强%李进华%赖以恒%李景伟%郝兴海%章良%戴江%孟旭%周其文
崔永超%來永彊%李進華%賴以恆%李景偉%郝興海%章良%戴江%孟旭%週其文
최영초%래영강%리진화%뢰이항%리경위%학흥해%장량%대강%맹욱%주기문
心脏瓣膜疾病%心脏瓣膜假体植入%心脏外科手术%主动脉瓣狭窄
心髒瓣膜疾病%心髒瓣膜假體植入%心髒外科手術%主動脈瓣狹窄
심장판막질병%심장판막가체식입%심장외과수술%주동맥판협착
Heart valve disease%Heart valve prosthesis implantation%Cardiac surgical procedures%Aortic valve stenosis
目的 总结主动脉瓣二瓣畸形所致的单纯主动脉瓣狭窄外科手术治疗经验.方法 1993年5月至2007年12月,共收治主动脉瓣二瓣畸形所致的单纯主动脉瓣狭窄病人103例,其中男66例,女37例.年龄15～75岁,平均(52.9±13.2)岁.心功能Ⅱ级58级,Ⅲ级33例,Ⅳ级12例.所有病人均接受主动脉瓣置换术,同期行左室流出道疏通2例、房颤射频消融2例、升主动脉替换7例,冠状动脉旁路移植11例.结果 手术死亡1例(死亡病0.93%),Ⅲ度房室传导阻滞1例,余者均治愈出院.随访6个月～14年,平均(86.3±26.8)个月.失访14例,随访率84.2%.3例出现脑出血或栓塞并发症,1例猝死,1例非心脏原因死亡.最后随访心功能Ⅰ级67例,Ⅱ级17例,Ⅲ级2例.结论 主动脉瓣置换治疗主动脉瓣二瓣畸形所致的单纯主动脉瓣狭窄有较好的疗效,合并升主动脉扩张应积极处理.
目的 總結主動脈瓣二瓣畸形所緻的單純主動脈瓣狹窄外科手術治療經驗.方法 1993年5月至2007年12月,共收治主動脈瓣二瓣畸形所緻的單純主動脈瓣狹窄病人103例,其中男66例,女37例.年齡15～75歲,平均(52.9±13.2)歲.心功能Ⅱ級58級,Ⅲ級33例,Ⅳ級12例.所有病人均接受主動脈瓣置換術,同期行左室流齣道疏通2例、房顫射頻消融2例、升主動脈替換7例,冠狀動脈徬路移植11例.結果 手術死亡1例(死亡病0.93%),Ⅲ度房室傳導阻滯1例,餘者均治愈齣院.隨訪6箇月～14年,平均(86.3±26.8)箇月.失訪14例,隨訪率84.2%.3例齣現腦齣血或栓塞併髮癥,1例猝死,1例非心髒原因死亡.最後隨訪心功能Ⅰ級67例,Ⅱ級17例,Ⅲ級2例.結論 主動脈瓣置換治療主動脈瓣二瓣畸形所緻的單純主動脈瓣狹窄有較好的療效,閤併升主動脈擴張應積極處理.
목적 총결주동맥판이판기형소치적단순주동맥판협착외과수술치료경험.방법 1993년5월지2007년12월,공수치주동맥판이판기형소치적단순주동맥판협착병인103례,기중남66례,녀37례.년령15～75세,평균(52.9±13.2)세.심공능Ⅱ급58급,Ⅲ급33례,Ⅳ급12례.소유병인균접수주동맥판치환술,동기행좌실류출도소통2례、방전사빈소융2례、승주동맥체환7례,관상동맥방로이식11례.결과 수술사망1례(사망병0.93%),Ⅲ도방실전도조체1례,여자균치유출원.수방6개월～14년,평균(86.3±26.8)개월.실방14례,수방솔84.2%.3례출현뇌출혈혹전새병발증,1례졸사,1례비심장원인사망.최후수방심공능Ⅰ급67례,Ⅱ급17례,Ⅲ급2례.결론 주동맥판치환치료주동맥판이판기형소치적단순주동맥판협착유교호적료효,합병승주동맥확장응적겁처리.
Objective Bicuspid aortic valve is thea most common reason cause forof aortic valve replacment in patients with isolated aortic stenosis. Severe valve calcification and ascending aorta dilation are often related to the bicuspid aortic valve. Proper surgical intervention of these patients are very importing, and it may improve affed.the long-term results.Our experience in surgical management of isolated aortic stenosis in atients with bicuspid aortic valve is reported. Methods From May. 1993 to Dec. 2007, 103 consecutive patients' data with of isolated aortic stenosis and with bicuspid aortic valve underwent surgery icalwere collected and analyzed treatm.ent. There were 66 males and 37 females, and aAge ranged from 15 years to75 years [mean(52.9±3.2 )years]. 58 Fifty eight patients were in heart function (NYHA) class Ⅱ, 33 cases were in class Ⅲ, and 12 cases in class Ⅳ. All patients received aortic valve replacement. Severe aortci aortic valve calcification existed were found in 55 patients,and ascending aorta dilation (aorta diameter largerthan > 4.5 cm) occurred in 7 cases. Concomitant procedures were as followingfollows: left ventricular out-flow obstruct correction in 2 cases, radio-frequency ablation for atrial fibrillation in 2 cases, ascending area replacement in 7 cases, and coronary artery bypass graft in 11 cases. Results Operative death occurred in 1 patient (mortality0.93%). Complete atrioventricular block occurred in 1 patient. Others The rest were all recovered and discharged. The follow-up ranged duration were from 6 months to 14 years [ (86.3 ± 6.8) months].14 casesFourteen patients lost in the follow-up. Three cases had Bbrain complications, occurred in 3 cases. Sudden death and no-cardiac death occurred in 1 patient, respectively. Heart function improved significantly after operation. 67 patients were in function class 1, 17patients were in Ⅱ, and 2 in class Ⅲ at the latest follow-up. Conclusion Aortic valvereplacement is an effective method for patients with bicuspid aortic stenosis trod bicuspid aortic valve. If patients associate withascending aorta dilation is associated, more aggressive method corresponding surgery should be considered.
