RESUMO
BACKGROUND:Heart valve surgery combined with coronary artery bypass grafting has been gradual y used for treatment of coronary heart disease combined with cardiac valve disease. OBJECTIVE:To retrospectively summarize the experience of combined coronary artery bypass grafting and valvular procedure. METHODS:Total y 51 patients who underwent combined heart valve surgery and coronary artery bypass grafting were retrospectively analyzed, including 10 cases with aortic valve replacement, 14 cases with mitral valve replacement, eight cases with mitral valve replacement combined with tricuspid annuloplasty, four cases with aortic valve and mitral valve replacement, three cases with aortic valve and mitral valve replacement combined with tricuspid annuloplasty, seven cases with mitral valvuloplasty, and five cases with mitral valvuloplasty combined with tricuspid annuloplasty. RESULTS AND CONCLUSION:Biovalve replacement was performed in nine patients, mechanical valves replacement in 31 cases, mitral valvuloplasty in 11 cases and tricuspid annuloplasty in 16 cases. There were total y 109 bypass graft vessels, and the average number of coronary artery bypass grafts was (1.92±0.73) branches. Four cases died within 30 days postoperatively, and 47 patients were successful y discharged from the hospital. Forty-five of 47 discharging patients were fol owed for 3-48 months. One case died of cerebral infarction within 6 months postoperatively, and another case died of cardiac dysfunction over 1 year after operation. The heart function of 45 survival patients was significantly improved. The comprehensive analysis showed that improving the heart function preoperatively, strengthening myocardial protection, shortening operation and myocardial ischemia time, and complete revascularization are the key factors for successful operation.
RESUMO
Objective: To review clinical characteristics of cardiac and pericardial hydatid cysts and assess the results of surgical treatment. Methods: From February 1978 to July 1999, 13 patients were diagnosed as heart and/or pericardium echinococcosis. There were nine male and four female. Their age ranged from 8 to 36 years ［mean (23.0±8.5) years］. 10 patients were symptomatic and 3 were asymptomatic. 3 patients had involvement of liver or lung. Pathologic cardiac murmur or cardiac enlargements were found in 10 patients. All patients were examined with chest roentgenograms, electrocardiogram and echocardiography. The serologic test was positive in 11 cases and negative in 3 cases. One right atrial cyst was removed under extracorporal circulation. 4 single pericardial cyst and multi-pericardial cyst were resected, 6 myocardial cysts and one complicated myocard ial and pericardial cysts were resected through puncture-aspiration endocystect omy. Results: All patients were followed up from six months to six years ［mean (3.5±1.5) years］. One late death occurred ten-month after operation, and the cause of death was heart failure. 3 patients had recurrence and were reoperated. Conclusion: The clinical characters may vary according to the number, size and location of cysts. Echocardiography is important for surgical planning. The results of endocystectomy of cardiac and pericardial echinococcosis were excellent.