摘要
安贞医院自１９９０年２月至１９９３年６月共实施各种三尖瓣手术２２９例。其中三尖瓣成形２１８例，三尖瓣置换１１例、占４％；其中男性３例、女性８例、平均年龄３２．６岁，心功能均在Ⅲ级以上，先天性心脏病Ｅｂｓｔｅｉｎ１例，三尖瓣发育不全２例，后天性心脏病中风心病６例、心内膜炎２例、均做了三尖瓣置换术，原位置换８例、房位置换３例、全部保留瓣膜６例，保留隔瓣４例，仅１例切除瓣膜，共用ＳｔＪｕｄｅ机械瓣９枚，牛心包瓣２枚。本文就三尖瓣置换术的适应征进行了探讨，认为在三尖瓣瓣叶尤其是前叶病理改变严重，或三尖瓣成形术后仍有关闭不全者应行换瓣手术。并就手术具体方法进行了改进：（１）风心病进行ＴＶＲ手术时应行原位瓣膜替换，自隔瓣根部稍上方进针，褥式带垫片缝合避免损伤传导束对前后瓣则行连续缝合；（２）对三尖瓣隔瓣发育不全者则行房位置换；（３）术中尽量多的保留三尖瓣及其附属装置；（４）本组选用中心血流，并且抗血栓性较好的生物瓣或双叶机械瓣。本组１１例术后无死亡，无并发症，随诊无心律失常。
Tricuspid valvular operations were performed in 229 cases,of which tricuspid valves were successfully replaced in 11 consecutive cases from Feb.1990 to Junel993.Three were male and 8 were female;the age ranged 8￣ 58 years. There were 3 cases of congenital heart disease cases (Ebstein' s anomaly 1case and tricuspid valvular hypoplasia 2 cases and 8 cases of acquired heart disease rheumatic heart disease 6 cases and endocarditis 2 cases Bioprothesis were used in 2 cases, and St.Jude prosthesis, in 9. Tricuspid valve was reserved in 6 cases partial reserved in 4 cases, and fofal resected in 1 case. The method of tricuspid replacement was recommended and The operative indications were discussed. The pastoperative complications were mainlyⅠ-Ⅱ°AVB. Most of tricuspid valvular replacement need-temporary pacing in early postoperative period.
出处
《心肺血管病杂志》
CAS
1995年第4期229-232,共4页
Journal of Cardiovascular and Pulmonary Diseases
关键词
瓣膜病
三尖瓣置换
心律失常
治疗
Valve disease,Tricuspid valve replacement,Arrhythmia
