Résumé
Objective To explore the effect of cardiac valve replacement surgery in the medium term on patients with giant left ventricular and its related risk factors.Methods Retrospective analysis the clinical data of 82 cases of valvular heart disease with giant left ventricle underwent heart valve replacement surgery.To compare the size and function of heart between preoperation and postoperation,and explore the relevant risk factors affecting the prognosis.Results The left atrial diameter,left ventricular end diastolic diameter,and left ventricular systolic diameter (LVESD) were decreased after the operation,and the difference was statistically significant (P ＜ 0.05).There was no significant difference between left ventricular ejection fraction and left ventricular shortening rate.But the NYHA classification showed significant difference (P ＜ 0.05).The risk factors related to the prognosis of patients were preoperative LVESD value ＞6.0 cm,heart function NYHA classification in grade Ⅳ,postoperative unuse of ACEI drugs or β-blockers (P ＜ 0.05).Conclusion The perioperative mortality is low in patients with valvular heart disease and giant left ventricle after heart valve replacement surgery.The curative effect is satisfactory,the shape and size of the heart in the medium term have obvious reverse remodeling process,and the cardiac function is also improved.Preoperative LVESD value ＞6.0 cm,heart function NYHA classification in grade Ⅳ,postoperative unuse of ACEI drugs or β-blockers are the major risk factors affecting prognosis of patients.