Korolev B A, Dobrotin S S, Kochedykova L V, Medvedev A P
Kardiologiia. 1977 Apr;17(4):30-6.
The course of the operative procedure of mitral valve prosthetic replacement was analyzed in 180 cases. All patients during perfusion developed certain disorders in the processes of excitation and myocardium conductivity that manifested themselves in different kinds of arrhythmias. In 23 cases ventricular fibrillation was recorded during the intervention, in 4 cases--a full atrioventricular block. The main causes of the severe arrhythmias consisted in coronary circulation disorders caused by temporary cross-damping of the aorta, air embolism, inadequacy of the perfusion, compression of the circumflex branch of the left coronary artery by a ligature or haematoma. Severe rhythm disorders usually occurred in patients with cardiomegaly and distinct dystrophic changes in the myocardium. Electric defibrillation was conducted after mitral valve prosthetic replacement in 57 patients for the management of chronic cardiac fibrillation, a positive effect being achieved in 47 of them. The most reasonable period for electroimpulse therapy in patients with IIA stage of circulation disorders is 3-4 weeks after surgery, while in those with IIB stage--5-6 months therafter.
对180例二尖瓣人工瓣膜置换手术过程进行了分析。所有患者在灌注过程中，兴奋和心肌传导过程出现了某些紊乱，表现为各种心律失常。术中记录到23例发生心室颤动，4例发生完全性房室传导阻滞。严重心律失常的主要原因包括主动脉暂时交叉阻断引起的冠状动脉循环障碍、空气栓塞、灌注不足、结扎线或血肿压迫左冠状动脉回旋支。严重的节律紊乱通常发生在心脏扩大且心肌有明显营养不良性改变的患者中。二尖瓣人工瓣膜置换术后，57例患者因慢性心脏颤动接受了电除颤治疗，其中47例取得了积极效果。对于循环障碍IIA期的患者，电脉冲治疗最合理的时期是术后3 - 4周，而对于IIB期的患者则是术后5 - 6个月。
