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Prosthetic Valve Endocarditis

Abstract: Prosthetic valve endocarditis(PVE) is a catastrophic complication of cardiac valve replacement, associated with high mortality rates. In the past nearly five decades, the microbiology, pathophysiology, clinical features, and therapeutic options in PVE have changed a lot, and there are new insight into the pathogenesis of PVE. The current comprehensive review will address various issues involved in the diagnosis and management of this complication.

Cardiac Valve Operation in Children

Objective To report the experiences of cardiac valve operation in children. Methods Cardiac valve operations were performed in 87 children who were 58 male and 19 female between age of 4 to 14 years (mean 10.2 years). Of the 87 patients, 36 underwent mitral valve replacement, 13 aortic valve replacement, 6 mitral and aortic valve replacement, 13 aortic valvuloplasty, and 19 mitral valvuloplasty. Associated cardiac lesions were simultaneously managed. Results Postoperative complications included low car...

Effects of Autologous Serum and γ-Interferon on Collagen Synthesis by Valvular Fibroblast in Patient with Rheumatic Heart Disease

Objective\ To understand the effects of serum of patients with rheumatic heart disease and γ interferon on collagen synthesis by valvular fibroblast cultured in vitro, so as to investigate the possible role of transforming growth factor β in genesis of valvular fibrosis and the possibility of γ interferon used to prevent valvular fibrosis in patient with rheumatic heart disease.\ Methods\ Mitral and aortic valve fibroblasts from 5 patients with rheumatic heart disease were cultured in vitro, the cultured ...

心内直视手术后气管切开及其处理方法

食管静脉性血管瘤一例

升主动脉和弓部动脉瘤的外科治疗

目的 总结升主动脉和弓部动脉瘤手术治疗经验,以期进一步提高手术疗效. 方法 自2000年7月至2002年5月应用深低温停循环(DHCA)和上腔静脉逆行脑灌注(RCP)技术手术治疗升主动脉和弓部动脉瘤20例,其中急症手术5例.施行全弓置换术2例,全弓置换和象鼻手术3例,半弓置换术15例.同期行Bentall手术8例,升主动脉置换术或同时行主动脉瓣置换术12例,冠状动脉旁路移植术1例. 结果 术后早期死亡1例,短时间浅昏迷1例,呼吸功能不全2例,肾功能不全2例,无晚期死亡. 结论 DHCA和RCP技术是手术治疗升主动脉和弓部瘤的安全、有效方法,急性A型夹层动脉瘤的手术方式取决于内膜破裂口的位置;正确掌握DHCA和RCP技术、手术方式和手术技术、围术期处理是提高手术疗效的关键因素.

右心房膨出瘤二例

左心房粘液瘤的外科治疗

目的 探讨左心房粘液瘤的诊断和治疗经验,以提高手术疗效. 方法 回顾性分析自1995年10月至2001年10月收治57例左心房粘液瘤病例,术前均经彩色超声心动图确诊,均在体外循环下行粘液瘤摘除术,同期行二尖瓣成形术5例,二尖瓣机械瓣置换术2例,三尖瓣成形术37例,房间隔缺损修补术2例,隔膜型主动脉瓣下狭窄环切开术1例. 结果 无围术期及手术死亡,随访1个月～6年,2例复发再次手术,捶⒙?.5%. 结论 左心房粘液瘤一经确诊应尽快手术,手术效果满意,复发率低;彩色超声心动图对诊断及术后随访有重要作用,应注意术后随访.

应用自体心包瓣置换术治疗主动脉瓣病变

目的　报告无支架自体心包瓣置换主动脉瓣手术的临床应用效果。　方法　11例单纯主动脉瓣病变患者行自体心包瓣置换主动脉瓣手术，术后定期随访。　结果　11例均存活，顺利出院，随访时间5～30个月，平均随访时间24.2±5.6个月。1例因中等量反流而行二次手术，其余10例心包瓣膜功能良好。　结论　该手术是一种治疗单纯主动脉瓣病变较为理想的方法，术后患者无需长期抗凝，手术近期效果满意，远期效果有待进一步随访。

先天性主动脉瓣二叶化畸形的外科治疗

目的 探讨先天性主动脉瓣二叶化畸形的诊断、适宜手术时机、围术期处理以及手术疗效. 方法 60例患者被施行心瓣膜置换术,行主动脉瓣机械瓣置换术56例,行自体心包瓣置换术4例;同时行主动脉窦瘤破裂修补术2例,胸主动脉瘤修补术2例,动脉导管未闭缝扎术3例,室间隔缺损修补术5例,冠状动脉旁路移植术3例.其中伴感染性心内膜炎25例. 结果 术后早期死亡5例,死亡率为8.3%.随访49例,平均随访时间5.4年,5年生存率为84.3%. 结论 先天性主动脉瓣二叶化畸形以男性居多,左、右二叶型较前、后型常见,可致主动脉瓣关闭不全和/或狭窄,以关闭不全多见(75%).出现充血性心力衰竭、心绞痛、晕厥、感染性心内膜炎时应尽早行手术治疗,症状不明显的患者应定期复查超声心动图,主动脉瓣置换术是常用的手术方法.