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首页> 外文期刊>Journal of Clinical and Diagnostic Research >Redo Mitral Valve Replacement for Prosthetic Valve Thrombosis: Single Center Experience
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Redo Mitral Valve Replacement for Prosthetic Valve Thrombosis: Single Center Experience

机译：重做二尖瓣置换术治疗人工瓣膜血栓：单中心经验

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Introduction: Prosthetic Valve Thrombosis (PVT) remains a significant cause of morbidity and mortality after valve replacement. Although surgical treatment is usually preferred as life-saving in cases of obstructive PVT, optimal treatment is yet to be decided.Aim: To evaluate risk factors and outcome of the patients undergoing redo mitral valve surgery for acute PVT.Materials and Methods: Between January 2012 and February 2015, 65 patients underwent redo surgery for obstructive PVT of mitral valve in Department of Cardiothoracic Surgery, UN Mehta Institute of Cardiology & Research Centre. Patients having acute PVT of aortic valve or combined aortic and mitral valve were excluded. Pre-operative, intra-operative and post-operative factors affecting the outcome as well as follow-up data were measured.Results: There were total 65 patients, 17 males and 48 females. Most common presenting symptom was dyspnea (100%), followed by palpitation (57.88%) and fatigue (29.45%). Total mortality was 29.2% (19/65). Mortality rate was significantly higher (16/35, 46%) in patients with direct surgery (Group-2) as compared to those with failed thrombolysis (3/30, 10%) (Group-1). Mortality was also significantly higher in patients presented with New York Heart Association (NYHA) III/IV class as compared to those presented with NYHA I/II class (p=0.02). All survived patients are NYHA Class I-II in follow-up with mean follow-up period was 24 ± 9 months.Conclusion: PVT still remains a challenging problem in a post-operative patient with a high mortality independent of treatment modality. Though life-saving, the surgical management of this condition still carries a high risk in haemodynamically unstable and in NYHA class III/IV patients.
机译：简介：人工瓣膜血栓形成（PVT）仍然是瓣膜置换后发病和死亡的重要原因。尽管通常在阻塞性PVT的情况下通常首选手术治疗来挽救生命，但仍未确定最佳治疗方法。目的：评估接受重做二尖瓣手术的急性PVT患者的危险因素和结果。 2012年和2015年2月，联合国Mehta心脏病与研究中心心胸外科的65例患者因二尖瓣梗阻性PVT接受了重做手术。排除主动脉瓣或合并二尖瓣和主动脉瓣急性PVT的患者。测量了术前，术中和术后影响预后的因素以及随访数据。结果：共有65例患者，男17例，女48例。最常见的症状是呼吸困难（100％），其次是心pa（57.88％）和疲劳（29.45％）。总死亡率为29.2％（19/65）。与溶栓失败的患者（3 / 30，10％）（第一组）相比，直接手术患者（第二组）的死亡率显着更高（16 / 35，46％）。纽约心脏协会（NYHA）III / IV级患者的死亡率也显着高于NYHA I / II级患者（p = 0.02）。所有存活的患者均接受NYHA I-II级随访，平均随访时间为24±9个月。结论：PVT仍然是高死亡率且不依赖治疗方式的术后患者的难题。尽管可以挽救生命，但这种情况的外科治疗仍然对血流动力学不稳定和NYHA III / IV级患者具有高风险。

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