The surgical treatment strategy and perioperative management of patients with heart valve disease complicated with severe chronic heart failure
10.7507/1007-4848.201902012
- VernacularTitle:合并慢性重度心力衰竭的心脏瓣膜病患者外科治疗策略选择及围手术期处理
- Author:
GUO Qiannan
1
;
LI Tian
2
;
ZHU Guizhi
1
;
KAN-PAATIB BARNABO NAMPOUKIME
1
;
PAN Youmin
1
;
LI Jun
1
;
WANG Haihao
1
Author Information
1. Department of Cardiovascular Surgery, Tongji Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology, Wuhan, 430030, P.R.China
2. Department of Operating Theatre, Tongji Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology, Wuhan, 430030, P.R.China
- Publication Type:Journal Article
- Keywords:
Valvular heart disease;
severe chronic heart failure;
surgical treatment;
perioperative management
- From:
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
2019;26(10):1004-1007
- CountryChina
- Language:Chinese
-
Abstract:
Objective To summarize the individualized selection of surgical treatment strategies and the key points of perioperative management for patients with heart valve disease complicated with severe chronic heart failure. Methods The clinical characteristics of 5 male patients with valvular heart disease complicated with severe chronic heart failure (CHF) were analyzed retrospectively from June 2017 to October 2018 in Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, with an average age of 60.21 years. Results Five patients were given angiotensin receptor and neprilysin inhibitor (ARNI)-based anti-heart failure treatment after admission. The operation mode of these patients was decided to be valve replacement under cardiopulmonary bypass after individualized evaluation of patients’ improving symptoms. Three patients were treated with intra-aortic balloon pump (IABP) and continuous renal replacement therapy (CRRT) early after operation to assist patients in improving cardiac function. Five patients recovered oral anti-heart failure after awakening. All patients were discharged smoothly 2 weeks after operation. Conclusion Individualized evaluation is needed for the choice of operation timing and mode, standardized preoperative treatment for heart failure, shortening the aortic blocking time during cardiopulmonary bypass, and early application of left ventricular adjuvant drugs or instruments are all important measures to help patients recover smoothly.
