目的：总结62例高龄患者心脏瓣膜病的手术治疗及结果。方法2012年2月至2013年1月心脏大血管外科施行的>60岁高龄患者心脏瓣膜手术的病例，其中行二尖瓣置换31例，主动脉瓣置换23例，二尖瓣联合主动脉瓣置换8例。同期行房颤射频消融术24例，左房血栓清除15例，三尖瓣成形术29例，左房折叠31例。共置换瓣膜70枚，生物瓣59枚、机械瓣11枚。结果术后早期死亡2例，病死率3.22%（2/62）。术后并发症：低心排血量综合征4例，呼吸功能不全8例，心律失常19例，急性肾功能不全8例，精神症状3例，无并发脑血管意外、切口愈合不良、精神症状，治疗后均痊愈出院。对其中52例患者随访3至8个月。结论只要掌握好手术指证，细致的手术操作，加强围手术期管理，高龄患者心脏瓣膜置换术可以取得良好的效果。%Objective Summarize the surgical treatment of 62 cases of elderly patients(>60 years)with heart valve disease and Results. Methods Between February 1,2012 to January 1,2013,62 patients aged 60years or older underwent cardiac valve operation. Line of mitral valve replacement 31 cases,23 cases of aortic valve replacement,8 cases mitral valve combined with aortic valve replacement. Line 24 cases of atrial fibrillation radiofrequency ablation during this period,the left atrial thrombus removal of 15 patients,tricuspid valvuloplasty 29 cases,31 cases of left atrial folding.,valve replacement 70 biological disc 59,mechanical valve 11 pieces. Results 61survived(96.78%)and 1 died(3.22%). Postoperative complications: low cardiac output syndrome in 4 cases,8 cases of respiratory insufficiency,arrhythmia(19 cases), acute renal insufficiency,8 cases of mental symptoms(3 cases),complicated with cerebrovascular accident,poor healing of incision,mental symptoms,were recovered from hospital after treatment. 52patients were followed up from 3 months to 8 months. Conclusion Although there are high risks in aged patients with valvular heart disease,the treatment Results could be satisfactory if we are able to select the right operating time and get all preparation with reasonable surgery strategy. The mortality and postoperative complication rate could be less.
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