| Objective: Discuss the surgical treatment of patients with low ejection fraction valvular heart disease,summarize the main points of surgery and perioperative treatment,and provide effective clinical basis for promoting the surgical treatment of patients with low ejection fraction valvular heart disease.Methods: From July 2018 to January 2021,101 patients with low left ventricular ejection fraction(LVEF <50%)who had undergone valve replacement in the Department of Cardiovascular Surgery of the Affiliated Hospital of Zunyi Medical University were included.According to the ejection fraction,they were divided into group A(n=45)(LVEF≤40%)and group B(n=56)(40%<LVEF<50%).The basic information,preoperative clinical data,surgical related data and postoperative related data of the two groups of patients were compared.Results:(1)There was no statistical difference between the two groups of patients in basic information such as gender,weight,previous disease history,cardiac function classification,laboratory examination and other preoperative related aspects(P >0.05).The medical history of the patients in group A(12[8.5,24]m)was significantly longer than that in group B(6[1.25,24]m)(P <0.05);In terms of disease composition ratio,the proportion of patients with aortic valve and mitral valve combined valvular disease in group A was significantly higher than that in group B(P <0.05).(2)In the aspect of operation,the operation time,extracorporeal circulation time,aortic block time and red blood cell infusion in group A(316.96±72.36min;157.22±36.97min;103.29±35.34min;3.79±1.55u)were significantly higher than those in group B(278.16±49.17min;137.09±23.69min;87.71±19.06min;3.09±2.02u)(P <0.05).(3)Postoperatively,there was no significant difference between the two groups in ECMO assistance,CRRT treatment and final mortality(P >0.05),but postoperative mechanical ventilation time,ICU stay time,total days of hospitalization,postoperative complications In terms of the incidence of symptoms,group A(36[27.5,69.5]h;65[44,114]h;36.13±11.95d;n=13(28.89%))was significantly higher than group B(18[12.5,42.75]h;45.5[38.5,73.25]h;29.16.18±9.86d;n=7(12.50%))(P <0.05).Preoperative one case LVEF18%,died after active treatment after the operation.(4)There was no statistically significant difference between the actual mortality of patients and the predicted mortality of Euro SCORE II model scoring system(P >0.05).Conclusion: The lower the ejection fraction,the higher the incidence of complications during the perioperative period;adult patients with low ejection fraction27%<LVEF <40% have a definite surgical treatment effect and good clinical effects;Euro SCORE II can better predict the postoperative patients death in this study.In adult valvular heart disease patients with low ejection fraction,strengthening preoperative adjustment of cardiac function,perfect intraoperative myocardial protection,and active adjuvant treatment during the perioperative period to maintain important organ functions can reduce the incidence of postoperative complications and Improve the treatment effect of patients with low ejection fraction. |
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