Hu S S, Zhu X D, Xiao M D
Cardiovascular Institute, Fuwai Hospital, Beijing.
Zhonghua Wai Ke Za Zhi. 1994 Jun;32(6):329-32.
From Apr. 1977 to Dec. 1992, 285 patients with giant heart (CTR > 0.70) underwent valve replacement. According to the index of cardiac chamber enlargement, the patients were clinically and morphologically classified in to four types. Type of left atrium (153 cases, 56.3%) is most common and has good surgical result. The operative mortality was reduced from 11.1% to 1.3%. Type of left ventricle (42, 15.2%) was high risk for surgical treatment, the operative mortality was 33.3%. Type of right cardiac enlargement (17 cases) is less common than other types, and is mainly for tricuspid valve incompetence. Type of total cardiac enlargement was found in 60 cases (22.1%), it was conventionally complicated with the disfunction of other organs with a higher operative mortality of 23.3%. We conclude that this classification represents the degree of cardiac chamber enlargement and the severity of heart disfunction, and has good coincidence with surgical result. It is helpful to identifying operative candidate for valve replacement with giant heart.
1977年4月至1992年12月，285例巨大心脏（心胸比率>0.70）患者接受了瓣膜置换术。根据心腔扩大指标，将患者在临床和形态学上分为四种类型。左心房型（153例，56.3%）最为常见，手术效果良好。手术死亡率从11.1%降至1.3%。左心室型（42例，15.2%）手术治疗风险高，手术死亡率为33.3%。右心扩大型（17例）比其他类型少见，主要为三尖瓣关闭不全。全心扩大型60例（22.1%），常合并其他器官功能障碍，手术死亡率较高，为23.3%。我们得出结论，这种分类代表了心腔扩大程度和心脏功能障碍的严重程度，与手术结果吻合良好。它有助于识别巨大心脏瓣膜置换术的手术候选者。
