CAJ | 학술논문

目的：介绍心脏瓣膜手术同期行冠状动脉旁路移植术的治疗体会。方法2003年5月至2013年12月，心脏瓣膜手术同期行冠状动脉旁路移植术29例，患者男性13例，女性16例。年龄35～70岁。共搭桥54根。二尖瓣成形术8例；主动脉瓣机械瓣置换术3例；二尖瓣机械瓣置换术10例；主动脉瓣置换及二尖瓣成形术4例；双瓣膜置换术4例。结果术后早期死亡5例，病死率17.24%，其中左室破裂2例，多器官功能衰竭2例，室颤1例。随访3～24个月，心功能改善，无严重心绞痛发作。结论风湿性瓣膜病患者，有冠心病高危因素者，应常规行冠状动脉造影检查。缺血性二尖瓣关闭不全者如瓣膜成形效果差时，应选择保留瓣下结构的瓣膜置换术。
목적：개소심장판막수술동기행관상동맥방로이식술적치료체회。방법2003년5월지2013년12월，심장판막수술동기행관상동맥방로이식술29례，환자남성13례，녀성16례。년령35～70세。공탑교54근。이첨판성형술8례；주동맥판궤계판치환술3례；이첨판궤계판치환술10례；주동맥판치환급이첨판성형술4례；쌍판막치환술4례。결과술후조기사망5례，병사솔17.24%，기중좌실파렬2례，다기관공능쇠갈2례，실전1례。수방3～24개월，심공능개선，무엄중심교통발작。결론풍습성판막병환자，유관심병고위인소자，응상규행관상동맥조영검사。결혈성이첨판관폐불전자여판막성형효과차시，응선택보류판하결구적판막치환술。
Objective?To?introduce?the?outcome??of??combined??valve??replacement??and???coronary??artery??bypass??grafting??in??patient??with??valvular?heart??disease??associated??coronary??heart??disease.?Methods?May?2003?to?December?2013,?heart?valve?surgery?over?the?same?period?coronary?artery?bypass?grafting?29?cases;?male?13?cases,?female?16?cases.?Age?35?to?70?years?old.?Total?bypass?54?root.?Results?5?cases?death?with?early?postoperative,?the?death?rate?was?17.24%,?Followed?up?for?3-16?months,?Patients?recovered?and?was?discharged?with??improved??heart??function.?Conclusion?Coronary?angiography?should be carried out routinely in patients with valvular heart disease, especially with coronary heart disease risk factors. Ischemic mitral insufifciency should choose?to?retain?disc?directly?under?the?structure?of?valve?replacement,?prevent?the?increased?mortality?and?postoperative?complications.