Discussion On Factors For Abnormal Rhythm Of Ventricles After Heart Valve Replacement Operation

Objective : In order to guide clinical operation, discussion on the relative factors, regularity for abnormal rhythm of ventricles after heart valve replacement.Methods: Separate 147 patients with mitral valve replacement (MVR), double valves replacement (DVR), left atrium thrombus eliminate and valve replacement (LATEVR) in 3 time segments by the way of operation, density of kalium, interdiction time of aortic artery, ratio of heart and breast, heart function, extra-corporeal circulation time, rhythm of the heart, blood pressure, central vein pressure and application of positive medicine for heart muscle. 60 hours after operation and in 5 phases record the times of abnormal rhythm of heart ventricles. Compare and study above figures.Results: 1. In the group of DVR , when kalium in blood serum is less than 3.5mmol/L .after operation 60 hours in 5 phases the ARHV (abnormal rhythm of heart ventricles) is 75%(9/12). Group of heart and breast ratio > 0.8, the ARHV is 57. 8%(11/19). Group with aortic artery interdiction time > 90 minutes , the ARHV is 46. 8%(30/46). Group of heart function grade IV, the ARHV is 57. 5%(46/80). 2 . In the group of LATEVR, when kalium in blood serum is less than 3. 5mmol/L , after operation 60 hours in 5 phasesthe ARHV is 76. 9%(10/13). Group of heart and breast ratio > 0. 8, the ARHV is 50%(5/10). Group with aortic artery interdiction time > 90 minutes , the ARHV is 58. 9%(23/39). Group of heart function grade IV, the ARHV is 48. 5%(34/70). 3. In the group of MVR, when kalium in blood serum is less than 3. 5mmol/L .after operation 60 hours in 5 phases the ARHV is 64%(16/25). Group of heart and breast ratio > 0.8, the ARHV is 48.2%(14/29). Group with aortic artery interdiction time > 90 minutes , the ARHV is 55. 1%(27/49). Group of heart function grade IV, the ARHV is 31.4%(50/159). The results indicates: There is an outstanding difference for following groups in P value: group of kalium in blood serum < 3. 5mmol/L and group of kalium in blood serum >4. 0 mmol/L, P is < 0. 01. Group with aortic artery interdiction time >90 minutes and < 60 minutes , P is < 0. 01. Group of heart and breast ratio >0. 8 and < 0. 8, P is < 0. 01. Heart function grade IV compared with II , P is < 0.01.Conclusions: The sequential factors for increase of abnormal rhythm of ventricles after heart valve replacement operation are as follows: group of kalium in blood serum < 3. 5mmol/L, group of aortic artery interdiction time >90 minutes, heart function grade IV, group of heart and breast ration is > 0. 8, group of extra- corporeal circulation time > 150 minutes, group of rhythm of heart is < 60 minutes, AMP < 50mmHg, CVP >20cmH20 and group with application of isoproterenol more than 48 hours.