黄方炯 张建群 杨禁非 吴强 伯平 尤斌 曹向戎 韩杰 黄国辉 许春雷 陈英淳 100029 北京,首都医科大学附属安贞医院心脏外科 中华心血管病杂志 1999 0 27 6


    关键词：心肌疾病；心脏外科手术 期刊 zhxxgbzz 0 心肌炎心肌病研究专栏 fur -->


    

【摘要 】 目的 报道12例左心室部分切除术治疗晚期扩张型心肌病的初步经验。方法 从1998年4～12月，12例扩张型心肌病患者接受了左心室部分切除术治疗。男10例,女2例,年龄36～53岁。术前心功能Ⅲ级5例，Ⅳ级7例。所有患者均有二尖瓣关闭不全，中度7例、重度5例；6例合并三尖瓣关闭不全。采用体外循环心脏停搏技术，切除左室心肌及二尖瓣成形。其中2例同时行左室内荷包缝合成形，5例同时行三尖瓣成形术。结果 左室心肌平均切除重量(44.8±12.5)g。术后超声心动图检查：左室舒张末期内径显著减少(78.6±8.4) mm至(62.6±11.4)mm，P<0.002 5，左室射血分数显著增加19.4%±7.8%至29.8%±8.9%，P<0.002 5。死亡3例(25%)。9例出院患者随访时间2～10(5.7±2.6)个月。1例于术后4个月死于慢性左心衰竭,1例心功能恢复到Ⅰ级，7例心功能Ⅱ级。结论 左心室部分切除术是一种新的、有效的治疗晚期扩张型心肌病的外科手术方法，但远期效果尚有待于进一步观察。

Partial left ventriculectomy forthe treatment of end-stage dilated cardiomyopathy

HUANGFangjiong, ZHANG Jianqun, YANG Jinfei, et al. Department of Cardiac Surgery, AnzhenHospital, Capital Medical University, Beijing 100029

【 Abstract 】 Objective To report our initial experience of the first 12 cases ofpartial left ventriculectomy (PLV or Batista operation), a new surgical therapy fortreatment of end-stage dilated cardiomyopathy in China. Methods From April to December 1998,12 patients with idiopathicdilated cardiomyopathy received PLV at Anzhen Hospital. The mean age of the patients was46 years (ranging form 36 to 53 years), 5 patients were in NYHA class Ⅲ and 7 in class Ⅳ . All patients had mitral valveinsufficiency (7 moderate and 5 severe) and 6 had tricuspid valve insufficiency inaddition preoperatively. Cardiopulmonary bypass and cardiac arrest with cold bloodcardioplegia were used in all patients. The average weight of the resected left ventriclemuscle was 44.8±12.5g.All patients underwent mitral annuloplasty and 5 plus a tricuspidannuloplasty (De Vega).Results Ecocardiography demonstrated a significant decrease in leftventricular diastolic diameter (78.6±8.4 to 62.6±11.4 mm, P<0.002 5) and increase ofejection fraction (19.4±7.8% to 29.8±8.9%, P<0.002 5).One patients &127;died of heart failure on 6th dayafter operation. Two patients died of sudden death. The mean followed-up period of the 9discharged patients were 5.7 months (from 2 to 10 months).Of the 9 patients followed up,one died of chronical heart failure four months after operation, one patient regained NYHAfunctional class I, and 7 of them, class II. Conclusion Batista operation is a new and valuable alternative forthe surgical treatment of end-stage dilated cardiomyopathy and the long-term results needfurther study.

     【 Key words 】 myocardial diseases heart surgery

左心室部分切除术是治疗晚期扩张型心肌病的一种新的手术方法 ......

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