Clinical effect of simultaneous heart valve surgery and coronary artery bypass surgery in the treatment of coronary heart disease with valvular disease / 中国基层医药

ABSTRACT

Objective:To investigate the clinical effect of simultaneous heart valve surgery and coronary artery bypass surgery in the treatment of coronary heart disease with valvular disease.Methods:From January 2014 to January 2018, 60 patients with coronary heart disease and valvular heart disease who admitted to Zhejiang Lyucheng Cardiovascular Hospital were selected in the prospective study.According to the random number table method, they were randomly divided into two groups, with 30 cases in each group.The observation group underwent heart valve surgery and coronary artery bypass grafting at the same time, while the control group underwent heart valve surgery first and then coronary artery bypass grafting at intervals.The recovery after operation, cardiac function index, quality of life score and incidence of complications after operation were compared.Results:(1)The ICU monitoring time[(5.29±1.04)d], duration of mechanical ventilation[(3.95±0.98)d] and hospitalization time[(13.59±2.84)d] in the observation group were shorter than those in the control group( t=4.205, 4.015, 3.997, all P<0.05). (2) After treatment, the left ventricular ejection fraction[(49.36±6.25)%] and stroke output[(76.29±5.31)mL] of the observation group were higher than those of the control group ( t=4.066, 4.093, all P<0.05), and the level of brain natriuretic peptide[(378.32±27.82)ng/L] was lower than that of the control group ( t=4.152, P<0.05). (3) After treatment, the scores of physical health, mental health, living environment and social relations in the observation group were (89.47±8.69)points, (84.49±8.21)points, (88.16±9.24)points and (85.46±8.95)points, respectively, which were higher than those in the control group ( t=4.139, 3.753, 3.859, 4.389, all P<0.05). (4)The total incidence of postoperative complications in the observation group was 3.33%(1/30), which was lower than 20.00%(6/30) in the control group (χ 2=4.043, P<0.05). Conclusion:Simultaneous heart valve surgery and coronary artery bypass grafting can reduce the postoperative complications of patients with coronary heart disease and heart valvular disease, accelerate the recovery rate and improve the heart function and quality of life.