[Current problems in the surgical treatment of acquired heart disease].
Two hundred and ninety patients with ischemic heart disease and two hundred and sixty one patients with valvular heart disease have been operated upon in our department. Combined valvular and coronary artery surgery was carried out in 19 cases, coronary artery and peripheral vascular surgery was carried out in 7 cases, and tricuspid valve replacement with SJM was carried out in 20 cases. Early mortality rate of combined valvular and coronary artery surgery was 26%, and late mortality 21%, however, only 3 cases (15.8%) died of LOS. Mortality rate of combined coronary artery and peripheral vascular surgery was 43%, however 1 patient died of LOS. Mortality rate of TVR with SJM was 15% which was rather low in comparison with other valves. A patient who underwent simultaneous surgical treatment of valvular or peripheral vascular disease, and coronary artery disease, ran almost the same risk of LOS as patients without ischemic heart disease. However, myocardial protection was important for these patients because of severe LV dysfunction and myocardial hypertrophy. There is not yet an ideal artificial valve for TVR. At present, SJM is the best available valve in terms of design and hemodynamics.
D000328:Adult; D000368:Aged; D002648:Child; D001026:Coronary Artery Bypass; D003327:Coronary Disease / Q000601:surgery*; D005260:Female; D006350:Heart Valve Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D014262:Tricuspid Valve Insufficiency / Q000601:surgery*