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目的探讨重症风湿性心脏瓣膜病变的外科综合治疗经验。方法胸心外科共收治28例重症风湿性心脏瓣膜病患者并进行了瓣膜置换术,其中二尖瓣置换(MVR)14例,二尖瓣、主动脉瓣双瓣置换AVR+MVR10例,主动脉瓣置换AVR4例,3例同时行改良三尖瓣DEVEGA法环缩。结果死亡1例(3.8%),死亡原因为心包填塞。随诊患者2月～2年,心功能显著改善。结论注重术前准备,选择适当手术时机,完善手术操作,避免手术不当引起并发症及加强术后并发症处理可进一步提高重症风湿性心脏瓣膜病的外科疗效。
Objective To investigate the surgical treatment of severe rheumatic heart valve disease. Methods Thoracic and cardiac surgery was performed in 28 patients with severe rheumatic valvular heart disease who underwent valve replacement. There were 14 cases of mitral valve replacement (MVR), 10 cases of AVR + MVR with bicuspid aortic valve replacement, 10 cases of aorta AVR 4 cases of valve replacement, 3 cases simultaneously modified DEVEGA tricuspid valve ring contraction. Results of death in 1 case (3.8%), the cause of death was pericardial tamponade. Follow-up patients 2 months to 2 years, cardiac function improved significantly. Conclusion The emphasis on preoperative preparation, selection of appropriate timing of surgery, improvement of surgical procedures, avoidance of complications caused by improper operation and enhancement of postoperative complications can further improve the surgical efficacy of severe rheumatic valvular disease.