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find Keyword "早期结果" 2 results
  • Ross-Konno 手术治疗儿童主动脉瓣及瓣下狭窄的临床疗效

    目的评价 Ross-Konno 手术治疗儿童主动脉瓣及瓣下狭窄的早期临床疗效。方法2018 年 12 月至 2019 年 12 月,共 12 例患儿因主动脉瓣及瓣下狭窄在我科接受手术治疗,其中男 8 例、女 4 例,接受手术时中位年龄 4 岁(11 个月~12 岁)。Ross-Konno 手术 11 例,单纯 Ross 手术 1 例。主动脉瓣重度狭窄 8 例,主动脉瓣关闭不全 2 例,狭窄合并关闭不全 2 例。合并主动脉二瓣化畸形 6 例,瓣下流出道显著狭窄 4 例,合并二尖瓣病变 4 例,合并弓部病变 3 例。手术采用自体肺动脉带瓣管道移植于主动脉瓣位,同期采用 Konno 法扩大左室流出道。采用牛颈静脉或带瓣 Gore-tex 人工血管重建右室流出道,并同期矫治心内合并畸形。所有患者均经多普勒彩色超声心动图定期进行随访评估。结果全组无手术死亡。术后中位随访时间 5.5(1~12)个月,1 例患儿残余左室流出道中度狭窄,其余患儿无显著左室流出道残余梗阻或复发梗阻,无新主动脉瓣显著反流。1 例患儿肺动脉带瓣管道主干中度狭窄,余重建右室流出道血流通畅,无明显瓣膜反流及赘生物形成。结论对于不适合瓣膜成形或置换术的儿童主动脉瓣膜病变,Ross-Konno 手术早期结果满意。

    Release date:2020-04-26 03:44 Export PDF Favorites Scan
  • Early outcomes of domestic left ventricular assist device implantation with or without concomitant mitral valvuloplasty

    Objective To compare the early outcomes of domestic third-generation magnetically levitated left ventricular assist device (LVAD) with or without concomitant mitral valvuloplasty (MVP). Methods The clinical data of 17 end-stage heart failure patients who underwent LVAD implantation combined with preoperative moderate to severe mitral regurgitation in Fuwai Central China Cardiovascular Hospital from May 2018 to March 2023 were retrospectively analyzed. The patients were divided into a LVAD group and a LVAD+MVP group based on whether MVP was performed simultaneously, and early outcomes were compared between the two groups. Results There were 4 patients in the LVAD group, all males, aged (43.5±5.9) years, and 13 patients in the LVAD+MVP group, including 10 males and 3 females, aged (46.8±16.7) years. All the patients were successful in concomitant MVP without mitral reguragitation occurrence. Compared with the LVAD group, the LVAD+MVP group had a lower pulmonary artery systolic pressure and pulmonary artery mean pressure 72 h after operation, but the difference was not statistically different (P>0.05). Pulmonary artery systolic pressure was significantly lower 1 week after operation, as well as pulmonary artery systolic blood pressure and pulmonary artery mean pressure at 1 month after operation (P<0.01). There was no statistically significant difference in blood loss, operation time, cardiopulmonary bypass time, aortic cross-clamping time, mechanical ventilation time, or ICU stay time between the two groups (P>0.05). The differences in 1-month postoperative mortality, acute kidney injury, reoperation, gastrointestinal bleeding, and thrombosis and other complications between the two groups were not statistically significant (P>0.05). Conclusion Concomitant MVP with implantation of domestic third-generation magnetically levitated LVAD is safe and feasible, and concomitant MVP may improve postoperative hemodynamics without significantly increasing perioperative mortality and complication rates.

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