Đặc điểm và kết quả phẫu thuật sửa chữa vỡ thất trái sau thay van hai lá

0 Người đánh giá. Xếp hạng trung bình 0

Tác giả: Hùng Dũng Văn

Ngôn ngữ: Vie

Ký hiệu phân loại:

Thông tin xuất bản: Phẫu thuật Tim mạch và Lồng ngực Việt Nam 2022

Mô tả vật lý: 18-25

Bộ sưu tập: Metadata

ID: 403487

Thêm vào giỏ Liên kết toàn văn

Có 18 trường hợp vỡ thất trái sau thay van hai lá (0,2 %). 94% bệnh nhân là nữ. tuổi trung binh lúc mổ là 57. Hẹp van 2 lá đơn thuần (11) hoặc hẹp 11Ở hai lá (6) hậu thấp chiếm đa số trường hợp. 6/18 có VÔI hóa vòng van sau
3/18 mổ lại sau 111Ổ thay van hai lá. Kích thước van được thay trung vị là 27 (25-29mm). Vờ type I: 03
type II: 1 và type III: 14. Thời gian xảy ra vỡ thất trái: sớm :5
muộn: 2 và trung gian: 11 tnrờng hợp. Tỳ lệ tữ vong là 61% (11/18) v ề kỳ thuật sừa chừa, 8 trường hợp khâu bên ngoài, không mở tim và 10 trường hợp kết hợp miếng vá bên trong và bên ngoài, tăng cường bằng keo sinh học. 100% có tuần hoàn ngoài cơ thề hồ trợ và 15/18 trường hợp được đặt bóng đối xung động mạch chủ. Kết luận: Cố gắng bảo tồn van sau tối đa, cắt van nhẹ nhàng, không cần lấy vôi hóa triệt đề ở vòng van sau là các biện pháp phòng ngừa vỡ thất trái. Áp dụng kỳ thuật sửa chừa vừa khâu miếng vá bên trong vừa khâu bên ngoài đi kèm phủ keo sinh học đà cho thấy hiệu quà cầm máu tốt, tỷ lệ thành công cao., Tóm tắt tiếng anh, There had 18 cases of left ventricular rupture after mitral valve replacement (0.2%). 94% of patients were female, the mean age at surgery was 57. Rheumatic mitral stenosis (11) or mitral disease (6) occurred ill the majority of cases. 6/18 has posterior annulus calcification
3/18 cases had reoperation after previous mitral valve replacement. The median valve size was 27 (25-29mm). Type I rupture 03
type II: 1 and type III: 14. Time of left ventricular rupture occurrence: early in 5
late in 2 and intennediate in 11 cases. The mortality rate was 61% (11/18). Regarding the repair technique, 8 cases of external repairs, without opening the heart and 10 cases of combined internal and external repairs, reinforced with bio-glue. 100% had supported by extracorporeal circulation and 15/18 cases had inserted intra-aortic balloon counterpulsation. Conclusion: preserve the posterior valve as much as possible, gentle resection of the diseased valve, and no need for radical decalcification of the posterior annulus are measures to prevent left ventricular rupture. The combined technique of internal and external repairs with bio-glue coating has shown a good hemostatic and high success rate.

1. Đọc trực tuyến

1. Đọc trực tuyến

Tạo bộ sưu tập với mã QR