| Objective:To summarize the clinical data of surgical revascularization of coronary heart disease with cardiac valve replacement at the same time in our hospital cardiac surgery from January 2013 to September 2018,evaluate the curative effect and accumulate clinical experience.Methods:From January 2013 to September 2018,108 patients undergoing surgical revascularization of coronary heart disease with cardiac valve replacement at the same time in our hospital cardiac surgery were selected.According to whether extracorporeal circulation was assisted during the operation or not,the patients were divided into two groups: off-pump bypass(group A)and on-pump bypass(group B).Some clinical indexes of the two groups before,during and after operation were counted.The clinical effects of the two methods were evaluated according to the comparison of the indexes of color Doppler echocardiography before operation and one week after operation,the days of hospitalization after operation,ICU stay time,invasive ventilator assist time,postoperative drainage volume,postoperative complications and adverse outcomes.Also according to the overall clinical data of patients,evaluate the effect of surgical revascularization of coronary heart disease with cardiac valve replacement at the same time.Results:In this study,the symptoms of the two groups were significantly improved after operation.The left ventricular eject fraction and left ventricular end diastolic dimension were improved after operation compared with that before operation.And there was significant difference between the two groups.There was no significant difference between the left ventricular ejection fraction after operation and that before operation.In group A,39 patients were hospitalized for 7 to 26(11.8±4.4)days after operation,in intensive care unit(ICU)for 19.5 to 159(69.4±33.8)hours,in invasive ventilator assist time for 3 to 104(31±28.2)hours,with postoperative drainage volume of 460 to 2090(1101.0±453.4)ml after operation.No death or serious illness was discharged automatically.In group B,69 patients were hospitalized for 6 to 46(13.9±8.1)days after operation,in intensive care unit(ICU)for 34 to 490.67(89±74.8)hours,in invasive ventilator assist time for 5 to 250.22(31.3±42.4)hours,with postoperative drainage volume of 450 to 2960(1223.5±524.0)ml after operation.3 patients died and 1 patient was discharged automatically.From January 2013 to September 2018,in total,108 patients underwent valve replacement and simultaneous bypass surgery.Days of hospitalization ranged was from 6 to 46(13.1±7.3)days,The length of stay in ICU was from 19.5 to 490.67(82.2±65.2)hours,the assistant time of invasive ventilator was from 3 to 250.22(31.2±38.3)hours,and the postoperative drainage volume was from 450 to 2960(1189.2±508.2).There were 3 deaths and 1 patient discharged from hospital automatically with a mortality rate of 3.7%.Conclusion:1.Valvular heart disease complicated with coronary heart disease is a high-risk disease with complex condition and high difficulty of operation.2.Surgical treatment can effectively improve the symptoms and quality of life of patients with valvular heart disease complicated with coronary heart disease.3.The off-pump beating Bypass Myocardial protection technique has a good effect in patients with valvular heart disease and coronary heart disease.It can be used as an alternative surgical scheme according to the patient's condition and the experience and habits of the operator.4.According to the clinical experience of the surgeon and the patient's condition,choosing individualized treatment plan can achieve good clinical efficacy. |
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