重度二尖瓣狭窄合并小左心室的外科治疗分析

目的总结重度二尖瓣狭窄合并小左心室的手术治疗经验。方法回顾性分析行二尖瓣置换术（MVR）的115例重度二尖瓣狭窄患者的临床资料。根据是否合并小左心室将患者分为小左心室组（61例）和非小左心室组（54例），对两组患者术后早期并发症发生率及病死率进行比较。结果小左心室组术后早期病死率、并发症发生率明显高于非小左心室组14．75％（9／61）比7．41％（4／54）、55．74％（34／61）比25．93％（14／54）]，差异均有统计学意义（P〈0．05）。结论积极而有效的围手术期处理及正确的术中决策是降低重度二尖瓣狭窄合并小左心室患者MVR术后早期并发症发生率及病死率的关键。

Surgical treatment of severe mitral stenosis associated with small left ventricle

Objective To summarize the experience of operation treatment of severe mitral stenosis associated with small left ventricle. Methods The clinical data of 115 patients with severe mitral stenosis received mitral valve replacement （MVR） were retrospectively analyzed. According to whether associated with small left ventricle,they were divided into small left ventricle group （61 cases） and non-small left ventricle group （54 cases）. The postoperative early complication rate and mortality rate between two groups were compared. Results The postoperative early complication rate and mortality rate in small left ventricle group was higher than that in non-small left ventricle group 14.75% （9/61） vs. 7.41% （4/54）,55.74% （34/61） vs. 25.93%（14/54） ], there was significant differenee（P 〈 0.05 ）. Conclusions The positive and effective perioperative management and correct intraoperative decision is key to reduce the incidence of early postoperative complications and mortality after MVR surgical in patients with severe mitral stenosis associated with small left ventricle.