心脏瓣膜置换术后左室破裂七例分析

摘要

Objective To analyze the cause of left ventricle rupture after valvular replacement. Methods Retrospective analysis of clinical data of 7 patients with left ventricle rupture after valvular replacement was made. Results There were 4 cases of type Ⅰ rapture and 3 cases of type Ⅱ rupture; There were one surviving and 6 dead. Conclusion A sudden rise in blood pressure is a common cause in left ventricle rupture after operation. Other causes are intraoperative hyper-valvula tissues and papillary muscles cut, drag overexerition, cardi-dilacerations by deep sewing needle, over diameter of embedded mechanical valve prosthesis, over crushed heart for exsufflation, especially super-valve frame in displacing biovalve.%目的 分析心脏瓣膜置换术后左室破裂的原因.方法 回顾性分析我院行心脏瓣膜置换术中发生左室破裂7例的临床资料.结果 7例中Ⅰ型破裂4例,Ⅱ型破裂3例；抢救成功1例,死亡6例.结论 术后血压突然增高是发生左室破裂的常见诱因,而术中剪除过多瓣膜组织及乳头肌、术中牵拉用力过度、缝针过深致心脏撕裂、植入的机械瓣膜直径过大,复搏时为了排气过分挤压心脏,特别是置换生物瓣膜时,瓣架高尖也是致左室破裂的原因.