巨大左心房与二尖瓣置换术：危险因素分析

Giant left atrium and mitral valve replacement: risk factor analysis.

作者信息

Di Eusanio G, Gregorini R, Mazzola A, Clementi G, Procaccini B, Cavarra F, Taraschi F, Esposito G, Di Nardo W, Di Luzio V

机构信息

Cardiac Surgical Department, Ospedale Civile, Teramo, Italy.

出版信息

Eur J Cardiothorac Surg. 1988;2(3):151-9. doi: 10.1016/1010-7940(88)90063-2.

DOI:10.1016/1010-7940(88)90063-2

PMID:2978788

Abstract

Giant left atrium (GLA) associated with mitral valve disease (MVD) has been reported as a significant risk factor in mitral valve surgery with mortality ranging from 8%-32%. Plication of the left atrium has been suggested to reduce postoperative left ventricular failure, respiratory failure and mortality. The 203 consecutive patients with MVD operated upon between 1980 and 1986 were reviewed and divided in two groups: group A without GLA (165 patients) and group B with GLA (38 patients = 19%). The pertinent preoperative and intraoperative notes and the early and late postoperative course were reviewed and correlated. The hospital mortality was 2.4% in group A and 2.6% in group B. Late mortality, at a mean follow-up of 54 months was 4.3% in group A and 5.4% in group B. In this series, GLA was not a significant risk factor in MVR and did not affect early and late results as compared with cases without GLA. Plication may not be required in absence of extracardiac signs of compression.

摘要

据报道，与二尖瓣疾病（MVD）相关的巨大左心房（GLA）是二尖瓣手术的一个重要风险因素，死亡率在8%至32%之间。有人建议对左心房进行折叠术以减少术后左心室衰竭、呼吸衰竭和死亡率。对1980年至1986年间连续接受手术的203例二尖瓣疾病患者进行了回顾性研究，并将其分为两组：A组无巨大左心房（165例患者）和B组有巨大左心房（38例患者 = 19%）。对相关的术前和术中记录以及术后早期和晚期病程进行了回顾并相互关联。A组的医院死亡率为2.4%，B组为2.6%。在平均随访54个月时，A组的晚期死亡率为4.3%，B组为5.4%。在本系列研究中，与无巨大左心房的病例相比，巨大左心房不是二尖瓣置换术的重要风险因素，也不影响早期和晚期结果。在没有心外压迫体征的情况下，可能不需要进行折叠术。