Factor Analysis Of Left Ventricular Function Recovery In The Early Postoperative After Elderly Patients With Aortic Valve Disease Undergoing Biological Valve Replacement

ObjectiveTo research and analysis in elderly patients factors affecting left ventricularfunctional recovery early undergoing aortic biological valve replacement surgery,forimproving the surgery.MethodsSelect our hospital’s222cases for the study group in June2009-July2012inelderly patients lining aortic biological valve replacement surgery. Male136cases,Female86cases, Age65~85(75.3±11.2) years old. Patients with pure aorticinsufficiency (AI group)68cases, Pure aortic stenosis (AS group)84cases, Aorticstenosis and regurgitation patients (AI+AS group)70cases.50randomly selectedcardiac ultrasound examination to exclude routine physical examination in patientswith cardiovascular disease as a control group, Preoperative clinical symptoms areshortness of breath, exertional angina, syncope, lower extremity edema, Cardiacfunction (NYHA) Class I6例, II grade68cases, III grade120cases, IV grade28cases. Cause of disease is rheumatic disease becomes148cases,58cases ofdegenerative, infectious endocarditis in10cases, six cases of ischemic valvulardisease, The main complications: hypertension86cases,18cases of renalinsufficiency, diabetes mellitus in25cases,26cases of coronary heart disease,arrhythmia in35cases,25cases of lung disease. ResultsThe research group of207cases of patients were cured,71cases (31.98%)complications:12cases of respiratory insufficiency, acute renal failure breaks eightcases, secondary thoracotomy in12cases, six cases of low cardiac output syndrome,wound healing in15cases,8cases of ventricular arrhythmias, multiple organ failurerest six cases, four cases of nervous system. Early operative death in15cases (6.76%),the main cause of death: acute renal failure rest two cases, one case of low cardiacoutput syndrome, ventricular arrhythmias four cases, multiple organ failure rest sixcases, two cases of cerebrovascular.207cases of early postoperative cardiac functionimproved. Class IV heart function before surgery, intraoperative aortic clamping timeand cardiopulmonary bypass time is too long, the type of aortic valve disease are afew main factors affecting recovery of left ventricular function, AI group earlypostoperative LVEF (%) and FS (%) compared with preoperative significantlyimproved, and AS+AS group and early postoperative LVEF (%) and FS (%) patientswith AI obvious improvement compared with the preoperative group.ConclusionsElderly patients with aortic valve disease, due to systemic dysfunction of variousorgans, tolerance variation, should actively preoperative preparation, choose theappropriate timing of surgery, improved surgical techniques and myocardialprotection methods, as well as the prevention of perioperative complications, get agood outcome. Cardiac surgery process, should try to shorten the time ofcardiopulmonary bypass and ascending aortic clamping time, reduce pathologicaldamage caused by cardiopulmonary bypass. Aortic valve disease in elderly patients,once the obvious symptoms, left ventricular hypertrophy and strain, should be surgeryto avoid entering class IV heart function, severe heart failure. When treatment inelderly patients with NYHA class IV had preoperative preparation time to try longer.