【摘要】 目的总结１９７５～１９９７年间６２例１４岁以下儿童人工心脏瓣膜置换术的经验，探讨儿童瓣膜置换的手术适应证、瓣膜选择和术后抗凝等问题。方法全组低温体外循环下行心脏瓣膜置换术，１７例使用生物瓣，４５例使用机械瓣。结果住院死亡１２例，晚期死亡１３例，术后失访４例，长期存活３３例；随访时间２～２５７个月，其中心功能Ⅰ级２８例，Ⅱ级５例，无１例因生长发育出现人工瓣膜相对狭窄。结论儿童人工心脏瓣膜置换术的死亡率高，宜慎重掌握适应证；儿童心脏瓣膜置换宜选择机械瓣更多还原

【Abstract】 Objective To evaluate the outcome of cardiac valve replacement from 1975 to 1997 in 62 children below 14 years old. Methods Hypothermic cardiopulmonary bypass was employed in 62 children.17 porcine valves and 45 mechanical valves were used. Results Hospital deaths were 12(19.4%), while late deaths 13(20.9%).Four cases lost follow up,there were 33(53.2%) long term survival cases. The follow up ranged from 2 to 257 months.Twenty eight children returned to NYHA class Ⅰ, and 5 class Ⅱ.No prosthetic valve stenosis was observed in the postoperative growth. No thromboembolism and bleeding occurred in the patients taking Warfarin. Conclusion The mortality was rather high in children’s cardiac valve replacement. Strict indication and mechanical valve were recommended for the cardiac valve replacement in children.更多还原