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我院于1979年6月至1987年12月共行换瓣术475例,早期死亡60例,其中12例死后尸检证实为瓣膜血栓栓塞,占死亡率之20%。12例中 MVR10例,AVR 及 AVR+MVR 各1例,生物瓣2例,倾斜型机械瓣10例.术前心功能Ⅲ级8例,Ⅳ级4例。心胸比率0.6～0.8。B 超示左房41～69mm。9例房颤,5例术中证实左房血栓形成。术后10例发生心低排出量综合征,9例心律紊乱,10例听诊瓣膜音欠清脆。4例在术后5～24小时内即开始抗凝治疗,5例24小时后进行抗凝,3例在抗凝治疗前已死
In our hospital from June 1979 to December 1987 a total of 475 valve replacement surgery, 60 cases of early death, of which 12 post-mortem autopsy confirmed valvular thromboembolism, the mortality rate of 20%. 12 cases were MVR in 10 cases, AVR and AVR + MVR in 1 case, bioprosthetic valve in 2 cases, inclined mechanical valve in 10 cases, preoperative heart function Ⅲ grade 8 cases, Ⅳ grade 4 cases. Cardiothoracic ratio 0.6 ~ 0.8. B ultrasound showed left room 41 ~ 69mm. 9 cases of atrial fibrillation, 5 cases of intraoperative confirmed left atrial thrombosis. Postoperative 10 patients had low cardiac output syndrome, 9 cases of heart rhythm disorders, 10 cases of auscultatory valve sounds less crisp. Four patients started anticoagulant treatment within 5 to 24 hours after surgery, 5 patients had anticoagulation after 24 hours, and 3 patients died before anticoagulant therapy