Clinical observation of coronary atherosclerosis combined with valvular heart disease

TAN Wei; LI Ru-zheng; XIE Ting

doi:10.3969/j.issn.1672-5301.2017.10.016

Abstract：Objective To explore the method and clinical effect of coronary artery bypass grafting and heart valve surgery in patients with valvular heart disease complicated with coronary heart disease,and to summarize the clinical data.Methods We retrospectively analyzed the postoperative cardiac function status and complication of 116 patients in our hospital from February 2013 to January 2017.Results The postoperative heart ultrasonography was performed.The results showed that the valve function was good and the cardiac function was improved.The left ventricular ejection fraction was significantly improved compared with that before operation.At the same time,coronary artery bypass grafting,mitral valve replacement,tricuspid valve formation in 46 cases,coronary artery bypass grafting,mitral valve formation in 31 cases,coronary artery bypass grafting,aortic valve replacement in 30 cases,coronary artery bypass,mitral valve combined with aorta valve replacement in 9 cases.There were 10 cases of low cardiac output syndrome,5 cases of cerebral infarction,5 cases of secondary thoracic hemostasis,7 cases of acute renal failure,3 cases of multiple organ failure and 1 death due to sudden cerebral hemorrhage.Conclusion Coronary artery bypass grafting and valvuloplasty or valvular replacement surgery should be performed in patients with high-risk heart valve disease with coronary artery disease with more than 50％ coronary artery stenosis.Preoperative comprehensive treatment to improve heart and lung function,intraoperative myocardial protection and reduce the time of cardiopulmonary bypass can effectively reduce mortality and complications,improve the surgical treatment.