Surgical Treatment of Severe Valvular Heart Disease

doi:10.3969/j.issn.1674-6805.2013.19.009

Abstract： Objective:To summarize the experiences of surgical treatment of severe valvular heart disease and discuss the methods of how to improve the operative success.Methods:106 patients with severe valvular heart disease received surgical treatment from October 1998 to January 2013.There were 41 males and 65 females,aged from 29 to 73 years,the average age was (41.2±15.6)years.Heart function(New York Heart Association Functional Classification) were classⅢ in 64 cases and class Ⅳ in 42 cases pre-operation.Mitral valve replacement was performed in 35 cases.Mitral valve repair in 1 case.Aortic valve replacement in 15 cases.Double valves replacement in 55 cases.Concomitantly,tricuspid valve repaire and coronary artery bypass grafting were applied in 41 and 18 cases respectively.Results:6 cases died early after operation(mortality rate 5.7%).Death causes include 2 cases of low cardiac output syndrome,1 case of ventricular arrhythmia,2 cases of multiple system organ failure and 1 case of cerebral infarct. 89 cases among 100 cases were followed up ranged from 1 month to 12 years, and among them,6 cases died(fatality rate 6.7%),48 cases were restored to heart function class Ⅰ,36 cases to class Ⅱ,and 5 cases to class Ⅲ .Conclusion:Surgical treatment of severe valvular heart disease should focus on correcting pathological changes of mitral valve and aortic valve,reserving the mitral subvalvular structure as much as possible,treating disordered tricuspid valve and selecting appropriate artificial valves.Meanwhile,we should focus on selecting appropriately operative timing,improving pre-surgical heart function and enhancing nutrition.These measures can be expected to improve the surgical outcomes of severe valvular heart disease and lower operative mortality.