Korolev B A, Dobrotin S S, Medvedev A P, Chiginev V A, Zoreva S P, Zemskova E N
Grud Serdechnososudistaia Khir. 1990(10):11-4.
The article analyses the results of surgical treatment of 1,394 patients with mitral stenosis who were operated on in the period between January 1, 1986 and April 1, 1989. Hospital mortality was 2.0%. Distinct indications for transventricular commissurotomy and mitral valve prosthetics were determined. The choice of the method for mitral stenosis correction was based on the character of the morphological changes in the cusps and subcuspal structures, which were determined during echocardiographic examination. With proper indications transventricular commissurotomy presents a small risk. Hospital mortality was 0.8% in mitral stenosis (among 1,039 patients who underwent operation 8 died) and 2.5% in recurrent stenosis (among 197 patients 5 died). Lethal outcomes were not encountered in stage 11, the mortality rate was 0.6% in stage III and 2.2% in stage IV. Mitral valve prosthetics was performed in 158 patients with 15 (9.5%) lethal outcomes. Hospital mortality was 4.5% in stage III and 10.3% in stage IV of the disease. In the group of patients with mitral stenosis hospital mortality was 7.5% (93 patients underwent operation). Hospital mortality after operations for recurrent mitral stenosis (65) was 12.3%. The initial severity of the patients' condition is still the main factor which influences unfavorably of the immediate results of mitral valve prosthetics.
本文分析了1986年1月1日至1989年4月1日期间接受手术治疗的1394例二尖瓣狭窄患者的手术结果。医院死亡率为2.0%。确定了经心室交界切开术和二尖瓣置换术的明确适应症。二尖瓣狭窄矫正方法的选择基于超声心动图检查确定的瓣叶和瓣下结构形态学改变的特征。在适当的适应症下,经心室交界切开术风险较小。二尖瓣狭窄患者的医院死亡率为0.8%(1039例手术患者中有8例死亡),复发性狭窄患者的医院死亡率为2.5%(197例患者中有5例死亡)。在II期未出现致命结果,III期死亡率为0.6%,IV期为2.2%。158例患者进行了二尖瓣置换术,其中15例(9.5%)出现致命结果。疾病III期的医院死亡率为4.5%,IV期为10.3%。二尖瓣狭窄患者组的医院死亡率为7.5%(93例患者接受了手术)。复发性二尖瓣狭窄手术后(65例)的医院死亡率为12.3%。患者病情的初始严重程度仍然是对二尖瓣置换术近期结果产生不利影响的主要因素。