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find Keyword "心脏瓣膜" 138 results
  • Echocardiography Expression in Heart Valve Damage with Rheumatoid Arthritis

    【摘要】随着超声心动图的普及与发展,无症状性类风湿性关节炎心脏瓣膜改变的检出率逐渐增多。临床应重视类风湿性关节炎心脏瓣膜损害以及超声心动图在这类疾病中的诊断价值,以期改善患者预后。【Abstract】 Objective More and more cardiac valve changes are detected in asymptomatic patients with rheumatoid arthritis by echocardiography. It is essential to pay attention to the clinical features of heart valves damage and the diagnostic value of echocardiography on that in order to improve the prognosis of patients.

    Release date:2016-09-08 09:45 Export PDF Favorites Scan
  • Cryomaze ablation procedure for atrial fibrillation concomitant with valve surgery

    Objective To summarize safety and effectiveness of cryomaze ablation procedure concomitant with valve surgery. Methods We retrospectively investigated the clinical data of 62 patients (24 males and 38 females) with mean age of 49.4±14.2 years who underwent cryomaze ablation procedure concomitant with valve surgery in our hospital from August 2013 through July 2015. The heart rhythm of the patients after surgery was supervised by 12-leads electrical cardiogram respectively. Results The rate of sinus rhythm restored right after surgery was 98.4%. The rate of sinus rhythm restored at the time of discharge was 93.4%. The rate of sinus rhythm restored 3 months, 6 months, 12 months, 18 months after surgery was 90.2%, 87.3%, 85.0%, 83.3% respectively. The one-year post-operation rate of sinus rhythm restored for the group of right minimal invasive thoracoscopic assisted mitral valve surgery was 90.5%. Longer duration for atrial fibrillation (>7 years) was a risk factor for the reoccurrence of atrial fibrillation 1 year after surgery (P<0.05). Conclusion Cryomaze ablation procedure concomitant with valve surgery is quite effective in treatment of rheumatic valve disease and atrial fibrillation. This approach is associated with fewer complications, comparable atrial fibrillation reoccurrence for short-term follow-up.

    Release date:2017-04-24 03:51 Export PDF Favorites Scan
  • Surgery for Combined Valvular and Coronary Atheroselerotie Heart Disease

    Technical advances both in cardiac surgery and relating to anesthesia,cardiopulmonary bypass and myocardial protection have significantly improved the prognosis for patients combined with coronary heart disease and heart valve disease. In addition to technology, variable factors that affect operative survival following combined operation include the severity of valvular disease, the number of coronary vessels affected, impairment of left ventricular function and both age and gender differences. In this article, we review the outcome of surgical intervention for heart valve disease combined with coronary heart disease and discuss future prospects in this field.

    Release date:2016-08-30 06:26 Export PDF Favorites Scan
  • 先天性心脏病合并感染性心内膜炎的外科治疗

    目的 总结先天性心脏病(congenital heart disease,CHD)合并感染性心内膜炎(infective endocarditis,IE)的外科治疗经验,以提高诊断、治疗效果。 .方法 .回顾性分析我院73例CHD合并IE患者行瓣膜手术的临床资料,对30例主动脉瓣感染性心内膜炎者行主动脉瓣置换术,另3例行Ross手术。在IE累及二尖瓣21例患者中,行二尖瓣成形术5例,二尖瓣置换术16例;10例主动脉瓣、二尖瓣IE行双瓣膜置换术;对6例肺动脉瓣IE患者行单瓣法做肺动脉瓣成形术2例,肺动脉瓣置换术4例,其中1例同期行主动脉弓置换;3例三尖瓣IE均行三尖瓣置换术。结果 主动脉瓣感染33例(45.2%),二尖瓣感染21例(28.8%),肺动脉瓣感染6例(8.2%),双瓣膜感染10例(13.7%),三尖瓣感染3例(4.1%)。血培养及赘生物培养总阳性率为23.3%,其中链球菌8例(47.1%),葡萄球菌3例(17.6%)。本组无手术死亡,除1例二尖瓣置换术后1年再次发生IE,拒绝手术治疗外,其余72例患者随访1年均治愈。 结论 CHD应尽早行根治性手术,以避免远期并发IE,损坏心脏瓣膜。对CHD合并IE出现瓣膜关闭不全者应尽快手术,如IE累及二尖瓣、三尖瓣且无瓣膜结构的严重损毁者,施行瓣膜成形术是较好的方法。

    Release date:2016-08-30 06:05 Export PDF Favorites Scan
  • Maze Ⅳ in the treatment of heart valve disease with persistent atrial fibrillation in elderly patients: A cohort study

    ObjectiveTo investigate the clinical effect of Maze Ⅳ in the treatment of elderly patients with valvular heart disease and persistent atrial fibrillation (AF).MethodsWe retrospectively analyzed the clinical data of 78 elderly patients with cardiac valve disease combined with persistent AF in our hospital from 2017 to 2018. The patients were allocated to two groups including a trial group (n=37) and a control group (n=41). There were 21 males and 16 females aged 61 to 74 (65.2±2.5) years in the trial group. There were 23 males and 18 females aged 62 to 76 (64.8±3.3) years in the control group. The clinical effects of the two groups were compared.ResultsThere was no statistical difference in baseline data between the two groups (P>0.05). The aortic occlusion time, extracorporeal circulation time, and operation time of the trial group were longer than those of the control group with statistical differences (P<0.05). There was no statistical difference in postoperative ventilator assistance time, complication rate, mortality, ICU retention time, perioperative drainage, red blood cell transfusion volume, or length of hospital stay between the two groups (P>0.05). At the time of discharge, postoperaive 1-month, 3-month, 6-month, and 12-month, the maintenance rates of sinus rhythm in the control group were statistically different from those of the trial group (P<0.05). Compared with the control group, left atrial diameter, left ventricular end diastolic diameter and the decrease of pulmonary artery systolic blood pressure were statistically different (P<0.05).ConclusionMaze Ⅳ is safe and effective in the treatment of elderly patients with valvular heart disease and persistent AF, which is conducive to the recovery and maintenance of sinus rhythm, and is beneficial to the remodeling of the left atrium and left ventricle and the reduction of pulmonary systolic blood pressure with improvement of life quality of the patients.

    Release date:2020-12-31 03:27 Export PDF Favorites Scan
  • 开放前热血加甘露醇灌注在危重心脏瓣膜疾病患者术中的应用

    目的 为了较好地进行心肌保护,研究主动脉开放前热血加甘露醇灌注在危重心脏瓣膜病患者体外循环术中的应用。 方法 选取我院1998年6月~1999年6月间80例心脏瓣膜病患者,随机分为实验组和对照组,每组各40例,常规行二尖瓣和/或主动脉瓣置换术。两组均采用中度低温含血心肌保护,实验组于主动脉开放前给予热血加甘露醇灌注。比较两组患者体外循环术后心功能恢复情况。 结果 在自动复跳率、主动脉开放后体外循环时间、24小时内心排血指数恢复速度、肌酸激酶下降幅度等指标实验组明显优于对照组(P<0.05),在术后呼吸机支持时间、ICU滞留时间、正性肌力药物使用率、手术死亡率等方面两组无明显差异(P>0.05)。 结论 主动脉开放前热血加甘露醇灌注能明显减轻再灌注损伤,加快术后早期心功能恢复。

    Release date:2016-08-30 06:33 Export PDF Favorites Scan
  • 右胸小切口微创二尖瓣手术同期行心房颤动双心房射频消融术

    目的总结右胸前外侧小切口微创二尖瓣手术同时行心房颤动(房颤)双心房射频消融术的临床经验。 方法回顾性分析2012年1~10月中国医科大学附属第一医院二尖瓣病变合并持续性心房颤动11例患者的临床资料,其中男4例、女7例,年龄(54.5±6.5)岁。所有患者均经股动静脉内插管建立体外循环,经第3或第4肋间入胸,经房间沟切口行二尖瓣手术,以单极笔行肺静脉口射频消融,以双极笔经右心房切口行右心房及右侧肺静脉口射频消融,封闭左心耳。缝合左右心房切口。2例行二尖瓣成形术,其余9例行二尖瓣置换术。 结果手术时间(282.9±67.8)min,体外循环时间(165.7±39.8)min,主动脉阻断时间(109.9±29.7)min,术后机械通气时间(7.4±3.2)h,住ICU时间(26.5±5.3)h,胸腔引流量(119.7±24.5)ml。随访时间(5.1±1.9)个月,术后3个月复查,窦性心律8例,阵发性心房颤动1例,持续性心房颤动2例。 结论经右胸前外小切口行微创二尖瓣手术同期行心房射频消融术,术后恢复快,美容效果好,临床疗效满意。

    Release date:2016-10-02 04:56 Export PDF Favorites Scan
  • Research progress of transcatheter aortic valve replacement-related new valve prostheses

    Transcatheter aortic valve replacement has revolutionized the management of aortic stenosis and become the gold standard for the treatment of symptomatic and severe aortic valve stenosis in elderly patients. With the improvement in design and materials, newer generation transcatheter aortic valve prostheses had overcome the limitations of early-generation devices that were susceptible to paravalvular leak, atrioventricular block and vascular complications, to a certain extent. This review provides an update on the latest advances in transcatheter aortic valve prostheses.

    Release date:2023-09-28 02:17 Export PDF Favorites Scan
  • Safety of the removal of pericardial and mediastinal drain within a different drainage volume after cardiac valvular replacement surgery: A case control study

    ObjectiveTo assess the safety of the removal of pericardial and mediastinal drain within different drainage volume after cardiac valvular replacement surgery.MethodsBetween July 2013 and July 2017, 201 patients with rheumatic heart disease (CHD) were treated with valve replacement in our hospital, including 57 males and 144 females, aged 15 to 72 years. They were divided into two groups according to the amount of 24-h drainage before the drain removal: a group one with 24-h drainage volume≤50 ml (n=127) and a group two with 24-h drainage volume>50 ml (n=74). The postoperative hospital stay and the incidence of severe complications between the two groups were compared.ResultsThere was no difference between the two groups in the baseline information or the incidence of severe pericardial effusion and tamponade, while the group two tended to have a shorter length of hospital stay after surgery (8.0 d vs. 7.5 d, P=0.013).ConclusionIn CHD patients undergoing valvular surgery, compared with a relatively low amount of drainage before the drain removal, drawing the tube at a greater amount of drainage (24-h drainage volume>50 ml) will shorten the length of hospital stay after cardiac surgery while incidence of severe complications remains the same.

    Release date:2019-01-03 04:52 Export PDF Favorites Scan
  • 右腋下小切口心脏直视手术3 012例的临床应用

    目的 总结右腋下小切口在心脏直视手术中应用的临床经验。 方法 2001年11月至2008年7月我们采用右腋下小切口施行心脏直视手术3 012例,男1 834例,女1 178例;年龄8个月~78岁,平均年龄124岁。行室间隔缺损修补术1 999例(干下型109例),房间隔缺损修补术677例(同期行三尖瓣或二尖瓣成形术107例、行部分型肺静脉畸形引流29例),法洛三联症矫治术43例,法洛四联症矫治术35例,右室双腔心矫治术33例,房室管畸形矫治、肺动脉瓣狭窄交界切开、右心室流出道狭窄疏通、三尖瓣下移畸形行11/2心室矫治或三尖瓣置换术等共123例,二尖瓣成形术28例,二尖瓣置换术74例。 结果 全组均顺利完成手术,早期死亡5例(0.17%),死亡原因分别为灌注肺、鱼精蛋白严重过敏、术中损伤左冠状动脉、低心排血量及脑血栓昏迷。二次开胸止血8例(0.26%),切口感染6例(0.20%),肺不张、灌注肺、低心排血量、感染性心内膜炎、急性肾功能衰竭(ARF)等并发症24例(0.79%);ARF患者均经连续床旁血液滤过治疗痊愈,其余患者经对症支持治疗痊愈。通过门诊复查、电话等形式随访1~82个月,共随访2 765例,失访247例;3例室间隔缺损出现小型残余漏,2例二尖瓣成形术后出现轻中度二尖瓣关闭不全,1例Ebstein畸形行三尖瓣成形术后出现轻中度三尖瓣关闭不全,其他患者无异常。 结论 右腋下小切口应用于心脏直视手术,有创伤小、失血少、切口美观等优点,但应严格掌握手术适应证。

    Release date:2016-08-30 06:02 Export PDF Favorites Scan
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