Sketch the bicuspid valve and close the treatment measure _'s treatment not complete

Sketch the bicuspid valve and close the treatment measure _'s treatment not complete
(1) Treatment of internal medicine departmentAvoid the excessive manual labor and violent and in motion appropriately, restrain sodium salt from taking in, protect the heart function; Prevent the streptococcus from being infected with to wind worry with membrane inflammation in rheumatism activity and infective heart actively; Use diuretic appropriately; Angiectasis pharmaceutical, especially lighten angiectasis pharmaceutical of after-load, penetrate blood resistance through reducing the left ventricle, can reduce and return to the flow, increase the heart and arrange blood volume, thus produce the beneficial dynamics function of blood flow. The chronic patient can use angiotensin invertase inhibitor. The acute one can use nitre general sodium, or Nitroglycerin, or the proper Lamine's vein of phenol is instilled. The foreign digitalis medicine should be used for presenting the patient in heart failure, there are more effective persons who quiver of atrium on accompanying. The heart failure patient in later period can prevent thromboembolism of thrombus with the anticoagulatory medicine.
(2) Surgery treatmentThe long-term follow-up study indicates, the bicuspid valve can not close completely the improvement of patient's heart function and is obviously superior to drug therapy after the surgery treatment; Even or in the the intersection of atrium and vibrant patient, surgery therapeutic curative effect obviously superior to drug therapy also in amalgamate in heart failure. Replace the mortality of the skill than the artificial valve low in repair technique of valve, the long-term survival rate is relatively high, the thromboembolism incidence of the thrombus is relatively little.
1.Prepare before the skillBefore surgery treatment, should walk on the left, the right heart conduit checked and left ventricle radiography. These check and return to flowing in making a definite diagnosis of the bicuspid valve, define it has very great help that the primary myocardium pathological change or functional bicuspid valve can not be closed completely; It contributes to appraising the pathological change severity which is given much trouble a leaf that dynamics of blood flow is checked; The radiography of coronary artery can confirm whether a patient needs to do in the bypass of coronary artery and transplanting the skill at the same time, because amalgamate and preceded the heart patient, the mortality of the operation is high, there are many complications.
2.Operation indication The acute bicuspid valve can not be closed completely; Heart function is 3- 4 grades, after internal medicine department treat actively; It is of 2 class or below that there is no obvious clinical symptom or heart function, auxiliary examination shows the going on increase of heart, the ejection fraction of left ventricle drops. Supersound aroused in interest to pursue, check left ventricle shrink internal diameter to reach 50mm or relaxation end the internal diameter up to 70mms end, ejection fraction should it less than or equal to 50%s to be in o'clock the intersection of surgery and treatment as soon as possible.
3.Operation kind The repair technique of valve: Can keep the natural valve to the maximum extent. Suitable for bicuspid valve relax due to prolapse; The chorde tendinae is too long or ruptures; Rheumatism bicuspid valve pathological change limitation, the frontal lobe is too soft to crease and the chorde tendinae although have fiber or calcification not to have contracture; The superfluous biological or perforated pathological change limitation of bicuspid valve of membrane inflammation in the infective heart, persons who do not have or only damage slightly of frontal lobe. The skill that the artificial valve is replaced: The valve replaced has machinery one and living beings one. Machinery petal including the intersection of ball and petal, floating the intersection of disc and petal slope dish one, its advantage is hard-wearing and strong, but the incidence of thrombus thromboembolism is high, need all the life anticoagulatory to treat, whom 10 years after the operation result from the reason that anticoagulatory and insufficient to cause thromboembolism of thrombus or anticoagulatory to excessively bleed die of illness and the invalid rate can be up to 50%; Secondly, the intersection of machinery and petal lean towards the intersection of disposition and blood flow, resistance relatively large to blood flow, step petal pigeonhole difference to be relatively high. One include pig aorta one, ox pericardium one and the same kind of hard meninx one in the living beings, advantage its thromboembolism rate low, it is anticoagulatory and having with natural petals of similar blood flow of centre all the life not to need for take place thrombus, one is firm but not as machinery. 3- Can take place after the 5 year the intersection of regression and the intersection of and calcification become but not damaged, about 50% need, change petal again after the 10 year.
Young patient and have the intersection of atrium and quiver or thromboembolism high to endanger and take the anticoagulatory persons who treat thrombus, should select the machinery one for use; If a ring is little, should select manpower one of dynamics of blood flow with better result for use; Bleed inclined to or anticoagulatory taboo person, and young women, change petal, plan, bear by gestation while being postoperative, should use the living beings one.
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