David T E, Dunin-Bell O, Orr S, Nguyen C
Can J Surg. 1983 Mar;26(2):157-9.
Of 316 patients who underwent operation for valvular heart disease at the Toronto Western Hospital, between January 1978 and December 1981, 41 (31 men, 10 women), ranging in age from 24 to 74 years, had severely impaired left ventricular function (ejection fraction less than 40% and left ventricular end-diastolic pressure more than 18 mm Hg). All 41 patients were in New York Heart Association (NYHA) class III or IV. Fourteen patients had disease of the aortic valve, 13 of the mitral valve and 14 of both aortic and mitral valves. Twenty-two patients also had serious coronary artery disease. The valve dysfunction was corrected in all patients by replacement or repair and all severe coronary artery stenoses were bypassed with saphenous vein grafts. There were three hospital deaths and five late deaths during a mean follow-up of 26 months (range from 6 to 48 months). All patients improved symptomatically by a least one functional NYHA class. The actuarial survival including operative deaths was 79%.
在1978年1月至1981年12月期间，于多伦多西部医院接受心脏瓣膜病手术的316例患者中，41例（31名男性，10名女性）左心室功能严重受损（射血分数低于40%且左心室舒张末期压力高于18毫米汞柱），年龄在24岁至74岁之间。所有41例患者均为纽约心脏病协会（NYHA）III级或IV级。14例患者患有主动脉瓣疾病，13例患有二尖瓣疾病，14例同时患有主动脉瓣和二尖瓣疾病。22例患者还患有严重的冠状动脉疾病。所有患者的瓣膜功能障碍均通过置换或修复得到纠正，所有严重的冠状动脉狭窄均通过大隐静脉移植进行搭桥。在平均26个月（6至48个月）的随访期间，有3例住院死亡和5例晚期死亡。所有患者的症状至少改善了一个NYHA功能级别。包括手术死亡在内的精算生存率为79%。
