Kurimoto Y, Inaoka M
Department of Thoracic Cardiovascular Surgery, Hakodate Goryoukaku Hospital, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1997 Nov;45(11):1866-9.
A 77-year-old woman was admitted to our hospital with congestive hepatic dysfunction and combined valvular disease. In addition to aortic stenosis, mitral stenosis, and tricuspid regurgitation, multi-organ dysfunction consisting of hepatic cirrhosis, pulmonary dysfunction and renal dysfunction were found. In consideration of the patient's anxiety for surgical treatment, we performed aortic valve replacement, open mitral commissurotomy and tricuspid annuloplasty. Although the patient required hemofiltration for 2 days and an assist of catecholamines for 1 month, she improved better and was discharged at 2 months after surgery. As preoperative assessment of preliminary function of other organs is difficult in the elderly, indications for surgery and optimal surgical procedures must be investigated in each case.
一名77岁女性因充血性肝功能不全合并瓣膜疾病入住我院。除主动脉瓣狭窄、二尖瓣狭窄和三尖瓣反流外，还发现存在由肝硬化、肺功能障碍和肾功能障碍组成的多器官功能障碍。考虑到患者对手术治疗的焦虑情绪，我们进行了主动脉瓣置换术、直视二尖瓣交界切开术和三尖瓣环成形术。尽管患者术后需要进行2天的血液滤过以及1个月的儿茶酚胺类药物辅助治疗，但她恢复较好，术后2个月出院。由于对老年人其他器官的初步功能进行术前评估较为困难，因此必须针对每个病例研究手术指征和最佳手术方案。
