Hata T, Namba H, Tsushima Y, Matsumoto M, Hikawa K, Sakamoto T, Hamanaka S, Fuziwara K, Taniguchi G
Department of Cardiovascular Surgery, Sakakibara Hospital, Okayama, Japan.
Kyobu Geka. 1994 Jul;47(8):645-9.
One thousand and three hundred patients underwent open heart surgery for acquired valvular diseases in our hospital from 1952 through December 1993. There were 105 reoperative cases through repeated median sternotomy incision and 52 cases of prosthetic valve replacement by the same operator in the last 5 years. We studied technical procedures by these reoperative experience. There was only one case (1.9%) of hospital death in replacement cases. We believe that repeated open heart surgery for acquired valvular diseases should be done prior to deterioration of patient's clinical condition. We had to pay attention to facilitate mobilization of right atrium and aortic root in the aortic and mitral valvular reoperations. To decrease operative mortality of prosthetic valve replacement, each operative techniques were necessary by the reasons for reoperation.
1952年至1993年12月期间,我院有1300例患者因获得性瓣膜疾病接受了心脏直视手术。其中有105例通过重复正中胸骨切开术切口进行再次手术,在过去5年中有52例由同一位手术医生进行人工瓣膜置换术。我们通过这些再次手术经验研究了技术操作。置换病例中仅有1例(1.9%)发生医院死亡。我们认为,对于获得性瓣膜疾病,应在患者临床状况恶化之前进行重复心脏直视手术。在主动脉瓣和二尖瓣再次手术中,我们必须注意便于右心房和主动脉根部的游离。为降低人工瓣膜置换术的手术死亡率,根据再次手术的原因,每种手术技术都是必要的。