Kollár A, Papp L
Semmelweis Orvostudományi Egyetem, Budapest.
Orv Hetil. 1992 Jul 19;133(29):1811-7.
As a result of increasing mean age of patient undergoing open heart surgery more and more combined valve and coronary surgery cases are performed. The operative risk of combined procedure is higher than that of valve replacement or coronary bypass grafting alone. In case of aortic valve disease the operation reduces the workload of the left ventricle thus decreasing the oxygen demand of the myocardium. In pure mitral valve stenosis as a consequence of valve replacement the left ventricular preload increases and coexisting coronary artery disease is of greater importance than in the other case. Since 1979 until the end of 1990 there were 146 combined operations performed in the Cardiovascular Surgical Clinic of Semmelweis Medical University of Budapest. The operative results and theoretical considerations are discussed.
由于接受心脏直视手术患者的平均年龄不断增加，越来越多的患者接受了瓣膜与冠状动脉联合手术。联合手术的手术风险高于单纯瓣膜置换术或冠状动脉搭桥术。对于主动脉瓣疾病，手术可减轻左心室的工作量，从而降低心肌的氧需求。在单纯二尖瓣狭窄的情况下，瓣膜置换后左心室前负荷增加，并存的冠状动脉疾病比其他情况更为重要。从1979年到1990年底，布达佩斯塞梅尔维斯医科大学心血管外科诊所共进行了146例联合手术。本文讨论了手术结果及理论依据。
