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41.
右胸小切口心脏不停跳二尖瓣置换术(附16例报告) 总被引:1,自引:1,他引:0
目的:介绍胸部小切口心脏不停跳二尖瓣置换术。方法:1997年3月至1998年9月,经腋下及腋前外小切口在浅低温体外循环下行二尖瓣置换术16例。结果:全组平均体外循环时间为45.2min,术后恢复良好,无栓塞、心律失常及脑部并发症,结论:胸部小切口心脏不停跳二尖瓣置术创伤小,恢复快,简便、安全、美容效果好。 相似文献
42.
目的 探讨经皮球囊扩张术治疗二尖瓣再狭窄的临床效果。方法 对19例闭式扩张术二尖瓣再狭窄(MRS)。和经皮二尖瓣球囊扩张术(PTMC)后MRS患者再次施行PTMC。结果 两组二尖瓣口面积(MVA)分别增加71%和78%。闭式扩张术后经再次PTMC,MVA从(1.35±0.34)cm^2提高到(2.31±0.32)cm^2,左房压(LAP)由(2.31±1.10)kPa降至(1.27±0.87)kP 相似文献
43.
二尖瓣病变患者多有活动后呼吸困难,探讨其运动时通气功能特点,方法:23例女性患者采用踏车运动测验,以10例正常女性作为对照。结果MVD组VO2ax/kg、VO2AT/kg、VEmax、VTmax、RRmax、VCO2max与DImax均低于对照组。 相似文献
44.
Grimes RY Hopmeyer J Cape EG Yoganathan AP Levine RA 《Echocardiography (Mount Kisco, N.Y.)》1996,13(4):357-372
A method for quantifying mitral and tricuspid regurgitant volume that utilizes a measure of jet orifice velocity U(0) - m/sec), a distal centerline velocity (U(m) - m/sec), and the intervening distance (X - cm) was recently developed; where jet flow rate (Q(cal) - L/min) is calculated as Q(cal) = (U(m)X)(2)/(26.46U(o)). This method, however, modeled the regurgitant jet as a free jet, whereas many atrial jets are counterflowing jets because of jet opposing intra-atrial flow fields (counterflows). This study concentrated on the feasibility of using the free jet quantification equation in the atrium where ambient flow fields may alter jet centerline velocities and reduce the accuracy of jet flow rate calculations. A 4-cm wide chamber was used to pump counterflows of 0, 4, and 22 cm/sec against jets of 2.3, 4.8, and 6.4 m/sec originating from a 2-mm diameter orifice. For each counterflow-jet combination, jet centerline velocities were measured using laser Doppler anemometry. For free jets (no counterflow), flow rate was calculated with 98% mean accuracy. For all jets in counterflow, the calculation was less accurate as: (i) the ratio of jet orifice velocity to counterflow velocity decreased (U(o)/U(c), where U(c) is counterflow velocity), i.e., the counterflow was relatively more intense, and (ii) centerline measurements were made further from the orifice. But although counterflow lowered jet centerline velocities beneath free jet values, it did so only significantly in the jet's distal portion (X/D > 16, i.e., >16 orifice diameters from the origin of the jet). Thus, the initial portion (X/D < 16) of a jet in counterflow behaved essentially as a free jet. As a result, even in significant counterflow, jet flow rate was calculated with >93% accuracy and >85% for jets typical of mitral and tricuspid regurgitation, respectively. Counterflow lowers jet centerline velocities beneath equivalent free jet values. This effect, however, is most significant in the distal portion of the jet. Therefore, regurgitant jets, although not classically free because of systolic atrial inflow or jet-induced intra-atrial swirling flows, will decay in their initial portions as free jets and thus are candidates for quantification with the centerline technique. (ECHOCARDIOGRAPHY, Volume 13, July 1996) 相似文献
45.
Intraoperative color Doppler recordings, obtained either from the epicardial or transesophageal approach, offer real-time information about the presence and severity of mitral regurgitation at the time of surgery. The technique allows instantaneous evaluation of mitral and tricuspid repair and may offer important information about the postoperative outcome. 相似文献
46.
Maternal and perinatal outcome in rheumatic heart disease. 总被引:6,自引:0,他引:6
H Sawhney N Aggarwal V Suri K Vasishta Y Sharma A Grover 《International journal of gynaecology and obstetrics》2003,80(1):9-14
OBJECTIVES: To study the maternal and perinatal outcome of pregnancies complicated by rheumatic heart disease. METHODS: A retrospective study was carried out in the cardio-obstetric clinic of the Postgraduate Institute of Medical Education and Research, Chandigarh (India) over a period of 13 years (1987-1999) involving 486 pregnant patients with rheumatic heart disease. Maternal and perinatal outcome was reviewed. RESULTS: Three hundred and four patients (63.3%) had single valve involvement and mitral stenosis was the most predominant lesion (89.2%). One hundred and seventy one (38.6%) patients had undergone surgical correction prior to the onset of pregnancy. One hundred and thirteen patients (22.6%) were identified as NYHA class III-IV. Mitral valvotomy was performed during pregnancy in 48 patients. The incidence of preterm birth and small for gestational age newborns was 12% and 18.2%, respectively. There were 10 maternal deaths, of which eight patients were NYHA III and IV. CONCLUSIONS: Rheumatic heart disease in pregnancy is associated with significant maternal and perinatal morbidity in NYHA class III-IV patients. 相似文献
47.
48.
In neonates with pulmonary atresia and intact ventricular septum the aims of therapy are maintenance of pulmonary blood flow
and right ventricular decompression in order to achieve right ventricular support of the pulmonary circulation. Recent developments
in interventional heart catheterization with pulmonary radiofrequency-assisted balloon valvuloplasty and ductal stent implantation
offer an alternative to the classical surgical approach. We report on a neonate with membranous pulmonary atresia and intact
ventricular septum, in whom a large interatrial right-to-left shunt via the foramen ovale persisted after radiofrequency-assisted
pulmonary balloon valvuloplasty on the 2nd day of life. The interatrial shunt prevented adequate right ventricular filling
and antegrade pulmonary perfusion leading to severe cyanosis (transcutaneous oxygen saturation 40%). In order to increase
pulmonary blood flow and raise left atrial pressure, the arterial duct was stented. After ductal stenting, prostaglandin was
discontinued and the transcutaneous oxygen saturation remained stable around 89%. At follow up after 7 weeks the foramen ovale
had decreased in size and only a small left-to-right shunt was present, documenting the effectiveness of this approach.
Conclusion Based on the present case we propose a stepwise interventional approach for the neonate with pulmonary atresia and intact
ventricular septum. If cyanosis persists after isolated pulmonary valvuloplasty despite adequate right ventricular function,
ductal stent implantation can reduce interatrial shunting and thus improve oxygen saturation.
Received: 12 January 1998 / Accepted: 15 February 1998 相似文献
49.
Primary Mitral Valve Sarcoma in Infancy 总被引:2,自引:0,他引:2
K. Itoh T. Matsumura Y. Egawa M. Watanabe T. Ohshio A. Ohta Y. Hayabuchi K. Seki 《Pediatric cardiology》1998,19(2):174-177
Primary cardiac sarcoma is a rare tumor, found especially in children, particularly in the left side of the heart. This report
describes a rare case of primary mitral valve sarcoma in a 7-month-old male infant with hemiparesis and heart murmur who underwent
mitral valve replacement because of excessive invasion of the mitral valve by the tumor. The patient remains well, free of
recurrence and cerebral metastasis, and without adjuvant therapy 18 months after the operation. 相似文献
50.
二尖瓣脱垂综合征163例分析 总被引:1,自引:0,他引:1
目的 了解二尖瓣脱垂综合征的临床表现。方法 对 16 3例二尖瓣脱垂综合征患者的症状、体征、心电图以及超声心动图进行分析。结果 (1)大部分患者无症状 ,有症状的主要表现为胸痛、心悸、头晕、乏力、焦虑等。典型体征为心尖区闻及喀喇音和收缩期杂音。 (2 )心电图表现各异 ,呈非特异性。 (3)超声心动图可直接观察二尖瓣脱垂部位、程度和二尖瓣关闭不全程度。结论 典型的症状、体征对发现本病有一定价值 ,但由于部分患者缺乏症状和体征 ,心电图表现非特异性 ,故诊断有赖于超声心动图 相似文献