Clinical Analysis Of Concomitant Surgical Treatment Of Cardiac Valvular Disease With Coronary Atherosclerotic Heart Disease

Objective : The clinical and surgical data of valvular heart disease with coronary atherosclerotic heart disease in our department for more than a year were collected.To investigate the perioperative precautions,surgical methods and clinical effects of valve replacement combined with coronary artery bypass grafting in patients with valvular heart disease complicated with coronary heart disease,and analyze the related factors affecting early death of patients,summarize the experience of diagnosis and treatment.It is expected to play a certain clinical guiding role in the treatment of such patients in the future?Methods:A total of 25 patients with heart valve replacement and coronary artery bypass grafting(CABG)were analyzed.And the operation methods,intraoperative data,main postoperative complications and management methods were summarized.At the same time,the changes of cardiac function classification(NYHA classification)and cardiac color doppler ultrasound before and after surgery were compared,the surgical efficacy was evaluated,the perioperative mortality and the incidence of various complications,especially serious complications,were counted,and the related factors affecting the early prognosis of patients were systematically analyzed.All the data were statistically processed by SPSS19.0 software.Results: 25 cases of operated patients,21 patients were cured,4 cases were death during hospitalization,and mortality was 16%,postoperative patients with cardiac function(NYHA classification)obviously improved compared with preoperative,all cases of renal failure in 1 case,postoperative pulmonary infection in5 cases,including severe infection in 2 cases,infection of incision,1 case,through full incision drainage and long-term treatment recovered after the treatment,thesecondary thoracotomy bleeding in 1 case,pericardial cavity effusion in 2 cases,1case of effusion amount is larger,recovered the pericardium puncture drainage under ultrasound guidance.Conclusion:1.Currently,the most effective surgical method for patients with heart valve disease complicated with coronary heart disease is simultaneous heart valve replacement combined with coronary artery bypass grafting,and most patients have a good recovery of cardiac function after surgery.2.The Lower left ventricular ejection fraction is an independent risk factor for early death of patients.Adequate preoperative preparation,reasonable surgical procedures,precise operation and good myocardial protection are the key to reduce the incidence of postoperative complications and mortality.