Surgical Treatment Of Cardiac Valve Disease In The Elderly

Objective: To sum up clinical experience of 256 cases patients over 65-year-old with artificial heart valve replacement surgery.Methods: We retrospectively analyzed clinical date of 256 cases over 65-year-old with artificial heart valve replacement. The cases were categorized as rheumatic valvular disease(RHD)(n=152), degenerative valvular disease(DVD)(n=70), congenital valvular disease(CHD)(n=30), and infective endocarditis(IE)(n=4).They were accompanied with coronary artery disease(CAD)(n=58), hypertension(n=43), diabetes mellitus(DM)(n=16), and chronic obstructive pulmonary emphysema (COPE) (n=13).We performed aortic valve replacement (AVR) in 54 cases, mitral valve replacement (MVR) in 148 cases, and double valve replacement (DVR) in 54 cases. Valve replacement combined with coronary bypass surgery (CABG) were performed in 20 cases.Results: Postoperative early complications occurred in 38 cases, including 13 cases of low cardiac output syndrome(LCOS), 2 cases of cardiac arrest, 1 case of cerebral embolism, 6 cases of lung complications, 2 cases of infective endocarditis, 1 case of mediastinal infection, 1 case of three degree atrioventricular block, 5 cases of acute renal failure, 2 cases of periprosthetic leakage, 2 cases of left ventricular rupture, 2 cases of serious hemorrhage followed to anticoagulant therapy, 1 case of septic shock. Postoperative early death occurred in 12 cases: 1 cases of mediastinal infection, 1 cases of cardiac arrest, 2 cases of lung disease complications, 4 cases of LCOS, 2 cases of acute renal failure, 1 case of left ventricular rupture, 1 case of septic shock.Conclusion: The essential factors for good effect of operation includes choosing operation juncture appropriately, adequate preoperative preparation, upstanding surgical skills and perioperative management, and proper anticoagulation therapy after surgery.