Pathology of Heart Valve Replacement Surgery:

Nelson R. Niles M.D. , John R. Sandilands M.A., M.D.
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引用次数: 20

Abstract

Hemorrhage in the atrioventricular conduction system and myocardial necrosis commonly occur in the first week after valve replacement. Later, thrombosis on the prosthesis and infarcts in other organs become important but developing or persistent myocardial damage continuously menaces. Occlusion of small vessels, especially by embolism of foreign material, may contribute to the development of these lesions. Although the extracorporeal circulation, anticoagulation, cardiac pacing and steroid therapy generally applied to patients undergoing Starr-Edwards valve replacement either are necessary to the surgery or effectively overcome some potent dangers, these practices may disguise progression to more serious levels of some maladies induced by operation. Data accumulating from these autopsies and from clinical records include many and varied complications of surgery.

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心脏瓣膜置换术的病理分析
房室传导系统出血和心肌坏死通常发生在瓣膜置换术后的第一周。后来,假体上的血栓形成和其他器官的梗死变得重要,但发展或持续的心肌损伤持续威胁。小血管的阻塞,特别是外来物质的栓塞,可能导致这些病变的发展。尽管体外循环、抗凝、心脏起搏和类固醇治疗通常应用于接受斯塔尔-爱德华兹瓣膜置换术的患者,要么是手术所必需的,要么是有效克服了一些潜在的危险,但这些做法可能掩盖了一些手术引起的疾病的更严重程度。从这些尸体解剖和临床记录中积累的数据包括许多不同的手术并发症。
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