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病例和方法 自1980年12月～1992年4月20例儿童接受了St.Jude人工瓣置换。年龄2～18岁,男性11例,女性9例,几例(55％)术前心功能Ⅲ～Ⅳ级(NYHA分类)。主动脉瓣置换9例,二尖瓣置换8例,3例为纠正性大血管转位接受了左房室瓣形态上三尖瓣的置换。17例术前有过23次手术。手术采用体外循环和全身低温方法,冷晶体或含血停跳液和心脏表面低温提供心肌保护,所有瓣膜植入均采用连续缝合技术。所有病例的华法令治疗自术后第2天开始,华法令剂量维持凝血酶原时间国际标准化比率(INR)为2～2.5,相当于凝血酶原时间比1.7～1.9。
Cases and Methods From December 1980 to April 1992, 20 children underwent St. Jude prosthetic replacement. Age 2 to 18 years old, 11 males and 9 females, a few cases (55%) preoperative heart function Ⅲ ~ Ⅳ grade (NYHA classification). Aortic valve replacement in 9 cases, mitral valve replacement in 8 cases, 3 cases of corrected major vessel transposition to accept the left atrioventricular valve morphology of the tricuspid valve replacement. 17 cases had 23 surgeries before surgery. Surgery using cardiopulmonary bypass and systemic hypothermia, cold crystals or blood-containing cardioplegia and cardiac surface hypothermia provide myocardial protection, all valve implantation using continuous suture technique. Warfarin treatment in all cases started at day 2 postoperatively, and the warfarin dose maintained an International Normalized Ratio (INR) of prothrombin time of 2 to 2.5, corresponding to a prothrombin time ratio of 1.7 to 1.9.