Early Evaluation Of Surgical Treatment Of Mitral Valve Disease Combined With Different Types Of Huge Left Atrium For Surgical Treatment

Objective:Observing the clinical characteristics of patients with mitral valve disease combined with different types of huge left atrium,changes in cardiac function during perioperative period and possible impact on early postoperative treatment characteristics,and summarize the experience of surgical treatment and early postoperative supportive treatment of various patients.Method: A total of 58 patients with rheumatic heart disease who were admitted to the Department of Cardiology at the First Affiliated Hospital of Guangxi Medical University from January 2018 to January 2019 were collected.The ratio of the left lateral diameter of the left atrium to the left thorax is the ratio of the left atrium to the left cardiothoracic,the ratio of the left lateral atrium to the right thorax is the ratio of the left atrium to the right cardiothoracic,according to the cardiothoracic ratio on both sides of the patient’s left atrium Different groups,the left cardiothoracic ratio of the left atrium ≥0.6 and the right cardiothoracic ratio <0.58(L type)are the first group;the left cardiothoracic ratio of the left atrium ≥0.6 and the right cardiothoracic ratio≥0.58(type B)are the first Two groups.The surgical method was transthoracic midline incision mitral valve replacement and left atrium folding,and was sent to the intensive care unit(ICU)for monitoring and treatment.Observe the patient’s ventilator-assisted ventilation time,monitoring time,and vasoactive drug use in the intensive care unit,and review the patient’s cardiac color Doppler ultrasound and chest radiographs one week after surgery for early efficacy evaluation.Result:There were no deaths during the perioperative period.The ventilator-assisted ventilation time of the first group was 19.02 ± 4.35 hours and the second group was 24.12 ± 16.13 hours.The difference between the two groups was statistically significant(P <0.01).The ICU monitoring time was50.17 ± 12.20 hours in the first group and 62.12 ± 25.08 hours in the second group.The difference between the two groups was statistically significant(P =0.003).The first group of routinely used vasoactive drugs dopamine and norepinephrine were 114.06 ± 59.11 hours and 64.13 ± 13.17 hours,respectively,and the second group were 123.14 ± 66.92 hours and 73.13 ± 48.00 hours.The difference between the two groups was statistically significant(P < 0.05).There were no deaths in the two groups of patients during the perioperative period,and they were all discharged smoothly.The patients were reviewed for changes in cardiac ultrasound and chest radiographs about 1 week after the operation.Postoperative left atrial diameter,left ventricular diameter,LVEF,LVFS,C / T were statistically different between the two groups after operation.Conclusion 1.Valve replacement and left atrium fold at the same time is an ideal method for the treatment of patients with mitral valve disease and huge left atrium.Early postoperative cardiac function is significantly improved compared with preoperative.2.The classification of the giant left atrium is helpful for the surgical treatment and perioperative management of mitral valve disease with giant left atrium.