Surgical Treatment Of Cardiac Valve Disease With Giant Left Ventricle

Objective To investigate the clinical features of patients with giant left ventricular valve disease,the efficacy of surgical treatment,and related risk factors that may affect recent postoperative death,and summarize the experience of surgical treatment.Methods This study collected 62 patients with giant left ventricular valvular heart disease who underwent valve replacement surgery in Department of Cardiothoracic Surgery,First Affiliated Hospital of Guangxi Medical University from January 2014 to January 2017.There were 40 male patients and 22 female patients.The male to female ratio was 1.8:1.Age 19-74 years old,mean age(42.00±10.36)years old.The preoperative,intraoperative,postoperative and follow-up data were collected,and the color Doppler ultrasonography and cardiac function were statistically analyzed before and after the operation and at the follow-up.Single factor was used to determine the causes of recent postoperative death,analysis.Results A total of 23 complications occurred in 62 patients with giant left ventricular valve disease,accounting for 37%.Four patients died in the hospital after surgery and the mortality rate was 6.5%.The patient’s echocardiography was reviewed 1 week after surgery.Compared with preoperative,postoperative LAD,LVEDD,and LVESD were all decreased compared with those before surgery.There was a statistically significant difference between the two groups(P<0.05).LVEF was lower than before surgery,and there was no contrast.Statistical significance(P>0.05).62 patients with giant left ventricular valve disease were divided into death group(4 cases)and survival group(58 cases).The results of univariate analysis showed that the disease history was ≥15 years,cardiac function class IV,LVEF≤0.4,and LVESD(mm)≥The difference between the two groups was statistically significant(P<0.05).A total of 47 patients were successfully followed up.The follow-up time was from 12 to 35 months.The follow-up rate was 81%.Follow-up patients had 2 deaths and a mortality rate of 4.3%.Survival of 45 cases of cardiac function improved significantly compared with preoperative,the comparison was statistically significant(P<0.05).At follow-up,the LVEF of the patient was significantly higher than that of the postoperative period,and the difference was statistically significant(P<0.05).The LAD,LVEDD,and LVESD were smaller than those after the operation,but the difference was not statistically significant(P>0.05).Conclusion 1.The effect of valve replacement in patients with giant left ventricular valve disease is good in the near and mid-term.2.Strengthening perioperative treatment is the key to improving postoperative outcome.3.A history of ≥15 years,NYHA class IV,LVESD ≥60mm,and LVEF≤0.4 are high risk factors that affect postoperative recent death.