重度肺动脉高压情况下的二尖瓣置换术。
Mitral valve replacement in the presence of severe pulmonary hypertension.
作者信息
Kaul T K, Bain W H, Jones J V, Lorimer A R, Thomson R M, Turner M A, Escarous A
出版信息
Thorax. 1976 Jun;31(3):332-6. doi: 10.1136/thx.31.3.332.
Thirty patients with severe preoperative pulmonary hypertension (pulmonary artery pressure range 90-165 mmHg, mean 118 mmHg) were reviewed following single mitral valve replacement, with prosthetic valves, within the last 10 years (1964-74). The early and late mortality for this group was no different from that of the total series of mitral valve replacements performed over the same period. Marked postoperative clinical improvement was accompanied by corresponding radiological and electrocardiographic changes. In addition there was a statistically highly significant haemodynamic improvement in the 21 survivors (mean survival time 5 1/2 years). At recatheterization the mean pulmonary artery pressure was 41-5%, the mean wedge pressure 46-3%, and the transpulmonary gradient (PAm-LAm) 36-1% of the preoperative values. It is concluded that gross pulmonary hypertension is not per se a contraindication to mitral valve replacement surgery.
回顾了过去10年（1964 - 1974年）内接受单瓣膜置换术（使用人工瓣膜）的30例术前患有重度肺动脉高压（肺动脉压范围90 - 165 mmHg，平均118 mmHg）的患者。该组患者的早期和晚期死亡率与同期进行的二尖瓣置换术全组患者无异。术后临床显著改善伴有相应的放射学和心电图变化。此外，21例存活者（平均存活时间5.5年）出现了具有统计学高度显著性的血流动力学改善。再次心导管检查时，平均肺动脉压为术前值的41 - 5%，平均楔压为46 - 3%，跨肺压差（PAm - LAm）为术前值的36 - 1%。得出的结论是，严重肺动脉高压本身并非二尖瓣置换手术的禁忌证。
Zotero 插件