巨大左心室瓣膜置换术的临床价值及其对心功能的影响

Clinical efficacy and heart functional recovery of valve replacement surgery for patients with giant left ventricle

摘要:

摘要：目的  探讨瓣膜置换术在巨大左心室患者临床治疗中的应用价值及其对心功能的影响。方法  选取2003年8月-2013年10月该院收治的37例患者。所有患者行瓣膜置换术进行治疗。分别对患者治疗前后不同时间超声心动图指标、心功能（NYHA）分级情况进行比较，并统计患者并发症及死亡情况。结果  与治疗前相比，患者治疗后1个月左心室舒张末期内径（LVEDD）和左心室收缩末内径（LVESD）下降，治疗后6个月LVEDD、LVESD及每博指数（SVI）下降，治疗后1年LVEDD、LVESD及SVI下降，左心室射血分数（LVEF）和左心室短轴缩短率（LVFS）提高。与治疗前相比，患者治疗后6个月和1年心功能Ⅰ、Ⅱ级比率提高，Ⅲ、Ⅳ级比率下降。患者术后早期死亡2例，死亡率为5.41%（2/37）。室性心律失常15例，低心排出量综合征14例，肺部并发症6例。结论  瓣膜置换术能够有效改善巨大左心室患者心功能，且近期术后并发症和死亡率较低，其远期疗效则需做进一步的临床随访研究。

Abstract:

Abstract: Objective To probe into the clinical application value of cardiac valve replacement surgery in the treatment of patients with giant left ventricle and its effect on heart functional recovery. Methods Thirty-seven patients treated in our hospital from August 2003 to October 2013 were selected. All the patients were treated with valve replacement surgery. The echocardiographic indices and cardiac function (NYHA) classification of the patients were compared at different time before and after treatment, and the complications and death situation were analyzed. Results The levels of LVEDD and LVESD were decreased 1 month after treatment; the levels of LVEDD, LVESD and SVI were decreased 6 months after treatment; the levels of LVEDD, LVESD and SVI were decreased, and LVEF and LVFS were increased 1 year after treatment compared with those before treatment. The ratio of cardiac function grade Ⅰ and Ⅱ was increased, the ratio of grade Ⅲ and Ⅳ was decreased 6 months and 1 year after treatment compared with those before treatment. There were 2 death cases in early postoperative period, the mortality was 5.41% (2/37). There were 15 cases with ventricular arrhythmia, 14 cases with low cardiac output syndrome, and 6 cases with pulmonary complications. Conclusions Valve replacement surgery could improve heart function and lower short-term post-operative complications and mortality in patients with giant left ventricle. Its long-term effects need further clinical follow-up study.