Comprehensive treatment of cardiac surgical patients with chronic left ventricular dysfunction
10.7507/1007-4848.201707033
- VernacularTitle:合并慢性左心功能不全心外科手术患者的综合治疗
- Author:
LI Jian
1
;
ZHANG Wei
1
;
GU Weili
1
;
ZHU Dan
1
Author Information
1. Department of Cardiac Surgery, Shanghai Chest Hospital, Shanghai Jiaotong University, Shanghai, 200030, P.R.China
- Publication Type:Journal Article
- Keywords:
Heart failure;
surgery;
neuroendocrine inhibition theory
- From:
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
2018;25(4):313-316
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the use of comprehensive treatment including drugs, devices and electrophysiology for heart failure patients with surgical indications. Methods We collected the clinical data of 65 consecutive cardiac surgical patients with chronic left ventricular dysfunction in our department between March 2014 and May 2016. There were 49 males and 16 females with an average age of 61.3±11.4 years ranging from 37 to 80 years. Their left ventricular ejection fraction was less than 40%. Patients with ventricular dysfunction caused by acute myocardial infarction were excluded. A comprehensive treatment strategy was performed according to patients’ individual disease. Results Fourty patients underwent cardiopulmonary bypass with asisting time of 55-400 (148.1±69.8) min; 35 patients needed cross-clamping with time of 44-203 (95.7±39.6) min. Intra-aortic balloon pump (IABP) was assisted in 3 patients. Two patients died in hospital. During the follow-up of 13.4 months, the patients’ cardiac function significantly improved and the heart size reduced. Two patients died and two were readmitted for heart failure. Four patients underwent cardiac pacemaker implantation. Other patients with unstable symptoms were stabilized after medical dose adjustment. Conclusion Under the concept of neuroendocrine inhibition, the comprehensive treatment for heart failure can effectively reduce surgical mortality and improve the patient’s quality of life.
