ObjectiveTo analyze long-term outcomes of aortic valve replacement (AVR) for patients with severe aortic regurgitation (AR) and left ventricular dysfunction (LVD). MethodsWe retrospectively analyzed clinical data of 44 patients with severe AR and LVD who received AVR in Drum Tower Hospital from January 2002 to December 2012. Left ventricular ejection fraction (LVEF) of all the patients was lower than 35%. There were 29 male and 15 female patients with their age of 23-78 (44±6) years and LVEF of 22%-34% (29%±3%). ResultsTwo patients died because of heart failure postoperatively. Cardiopulmonary bypass time was 57-92 (73±8) minutes, aortic cross-clamping time was 33-61 (48±6)minutes, and length of ICU stay was 2-15 (8±3) days. All the patients were followed up for 1-11 (4.3±2.9) years. Two patients died during follow-up because of heart failure and stroke respectively. One-year survival rate was 93% and five-year survival rate was 91%. ConclusionAVR can significantly increase long-time survival of patients with severe AR and LVD.
ObjectiveTo evaluate the clinical efficacy of tricuspid valve re-operation after left cardiac valve surgery. MethodsWe retrospectively analyzed the clinical data of 23 patients underwent tricuspid valve re-operation in the Affiliated Drum Tower Hospital of Medical School, Nanjing University from January 2009 to November 2014. There were 3 males and 20 females with a mean age 53.48±10.79 years ranging from 34 to 71 years. The average body mass index of the 23 patients was 21.77±2.42 kg/m2. We followed up all the patients in outpatient department or through telephone for 3 months to 5 years. ResultsAll surgeries were operated under cardiopulmonary bypass. There were 15 patients underwent operation through medisternal incision and 8 patients underwent operation through the fourth intercostal incision of right anterolateral side. The mean operation time was 284.35±56.16 minutes and the mean time of cardiopulmonary bypass was 138.61±46.91 minutes. One patient died postoperatively and 2 patients chose to discharge automatically after operation. The other 20 patients recovered and discharged uneventfully. We followed up the patients for 3 months to 5 years. One patient underwent permanent pacemaker therapy for atrioventricular block, 3 patients accepted pharmaceutical therapy for atrial arrhyttmia, 1 patient underwent re-operation for infectious endocarditis of left cardiac artificial valve. and the follow-up conditions of the rest patients were well. Besides, the follow-up data showed that there was a mild regurgitation in 3 patients underwent tricuspid valve plasty. ConclusionTricuspid valve re-operation after left cardiac valve surgery can take multiple surgical pathways and strategies. The clinical effect has been proved and the midterm follow-up condition is well, but we still need the long-term follow-up for the further effect.