目的 总结老年危重心瓣膜病患者的手术治疗和围术期处理经验。 方法 回顾性分析 2008年6月至2010年6月中国医科大学附属第一医院37例60岁以上老年危重心瓣膜病患者手术治疗的临床资料,其中男21例,女16例;年龄60~79 (67.3±6.9)岁。二尖瓣病变15例,主动脉瓣病变8例,主动脉瓣+二尖瓣病变14例;合并左心房血栓9例,三尖瓣反流11例。 结果 围术期死亡3例,其中死于术后肺部感染1例,多器官功能衰竭1例,脑梗死1例。术后发生并发症18例,包括呼吸道并发症、室性心律失常、低心排血量综合征和急性肾功能衰竭等,经相应的治疗治愈。随访26例,随访时间6~23个月,心功能分级(NYHA)Ⅰ级13例,Ⅱ级12例,Ⅲ级1例。 结论 完善的术中操作、加强围术期处理,可有效降低老年危重心瓣膜病患者术后并发症的发生和病死率。
Citation:
房勤,谷天祥,刘波,王春,张玉海,卢春茂. 老年危重心瓣膜病的外科治疗与围术期处理. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2013, 20(1): 111-112. doi:
Copy
Copyright © the editorial department of Chinese Journal of Clinical Thoracic and Cardiovascular Surgery of West China Medical Publisher. All rights reserved
1. |
mitral valve disease:epidemiology and prognostic implications. Semin Thorac Cardiovasc Surg, 2010, 22 (1):69-75.
|
2. |
Srinivasan AK, Oo AY, Grayson AD, et al. Mid-term survival after cardiac surgery in elderly patients:analysis of predictors for increased mortality. Interact Cardiovasc Thorac Surg, 2004, 3 (2):289-293.
|
3. |
许锁春, 闫炀, 耿希刚, 等. 急诊外科手术治疗危重心瓣膜病192例. 中国胸心血管外科临床杂志, 2009, 16 (4):312-314.
|
4. |
Martínez-Sellés M, Hortal J, Barrio JM, et al. Treatment and outcomes of severe cardiac disease with surgical indication in very old patients. Int J Cardiol, 2007, 119 (1):15-20.
|
5. |
Conti V, Lick SD. Cardiac surgery in the elderly:indications and management options to optimize outcomes. Clin Geriatr Med, 2006, 22 (3):559-574.
|
6. |
Urban M, Pirk J, Turek D, et al. In patients with concomitant aortic and mitral valve disease is aortic valve replacement with mitral valve repair superior to double valve replacement? Interact Cardiovasc Thorac Surg, 2011, 12 (2):238-242.
|
7. |
程实, 修宗谊, 谷天祥, 等. 重症心脏瓣膜病心瓣膜置换术体外循环经验. 中国胸心血管外科临床杂志, 2009, 16 (5):402-402.
|
8. |
Anderson AJ, Barros Neto FX, Costa Mde A, et al. Predictors of mortality in patients over 70 years-old undergoing CABG or valve surgery with cardiopulmonary bypass. Rev Bras Cir Cardiovasc, 2011, 26 (1):69-75.
|
9. |
Anyanwu AC, Adams DH. Functional tricuspid regurgitation in.
|
10. |
Lindqvist P, Zhao Y, Bajraktari G, et al. Aortic valve replacement normalizes left ventricular twist function. Interact Cardiovasc Thorac Surg, 2011, 12 (5):701-706.
|
11. |
Kovács E, Becker D, Daróczi L, et al. Analysis of vascular complications of IABP therapy in open-heart surgery patients 1999-2004. Magy Seb. 2006, 59 (2):105-111.
|
- 1. mitral valve disease:epidemiology and prognostic implications. Semin Thorac Cardiovasc Surg, 2010, 22 (1):69-75.
- 2. Srinivasan AK, Oo AY, Grayson AD, et al. Mid-term survival after cardiac surgery in elderly patients:analysis of predictors for increased mortality. Interact Cardiovasc Thorac Surg, 2004, 3 (2):289-293.
- 3. 许锁春, 闫炀, 耿希刚, 等. 急诊外科手术治疗危重心瓣膜病192例. 中国胸心血管外科临床杂志, 2009, 16 (4):312-314.
- 4. Martínez-Sellés M, Hortal J, Barrio JM, et al. Treatment and outcomes of severe cardiac disease with surgical indication in very old patients. Int J Cardiol, 2007, 119 (1):15-20.
- 5. Conti V, Lick SD. Cardiac surgery in the elderly:indications and management options to optimize outcomes. Clin Geriatr Med, 2006, 22 (3):559-574.
- 6. Urban M, Pirk J, Turek D, et al. In patients with concomitant aortic and mitral valve disease is aortic valve replacement with mitral valve repair superior to double valve replacement? Interact Cardiovasc Thorac Surg, 2011, 12 (2):238-242.
- 7. 程实, 修宗谊, 谷天祥, 等. 重症心脏瓣膜病心瓣膜置换术体外循环经验. 中国胸心血管外科临床杂志, 2009, 16 (5):402-402.
- 8. Anderson AJ, Barros Neto FX, Costa Mde A, et al. Predictors of mortality in patients over 70 years-old undergoing CABG or valve surgery with cardiopulmonary bypass. Rev Bras Cir Cardiovasc, 2011, 26 (1):69-75.
- 9. Anyanwu AC, Adams DH. Functional tricuspid regurgitation in.
- 10. Lindqvist P, Zhao Y, Bajraktari G, et al. Aortic valve replacement normalizes left ventricular twist function. Interact Cardiovasc Thorac Surg, 2011, 12 (5):701-706.
- 11. Kovács E, Becker D, Daróczi L, et al. Analysis of vascular complications of IABP therapy in open-heart surgery patients 1999-2004. Magy Seb. 2006, 59 (2):105-111.