Journal of Chest Surgery

The Korean Society for Thoracic and Cardiovascular Surgery (대한심장혈관흉부외과학회)
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Changes in Pulmonary Function in Mitral Valve Disease Following Mitral Valve Replacement

승모판질환에서 승모판치환술에 따른 폐기능의 변화

  • 이응배 (경북대학교 의과대학 흉부외과학교실) ;
  • 김덕실 (경북대학교 의과대학 흉부외과학교실)
  • Published : 1996.09.01
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Abstract

Bet een November 1991 and December 1993, twelve patients (Male: 2, Female: 10) who had mitral valve disease without primary pulmonary disease underwent mitral valve replacement. The pulmonary function test (PFT) was performed preoperatively and postoperatively (mean, 9 months after operation). Mitral valve replacement was indicated for mitral stenosis in 9 patients and for mitral insufficiency in 3 patients. Preoperative WHh functional class were 111 in 11 patients and class rV in 1 patient. Postoperatively, ten patients (83 %) were classified into NYHA functional class 1. There was a significant decrease in cardiothoracic ratio (CTR) postoperatively (p< 0.05). The pulmonary function before operation was low compared with predicted values in vital capacity (VC) and forced mid-expiratory flow (FEF 25∼75 %). The FEF 25%-75% and maximal voluntary ventilation (MW) were low compared with predicted values postoperatively. There was no significant difference in the pulmonary function before an after op- eration. Twelve patients were divided into 2 groups according to the early postoperative NYHA functional class. In class I group, the postoperative pulmonary function was significantly improved in 6 parameters (RV, FRC, TLC, FEVI , FEVI /FVC, and FEF 25∼75%), but in class ll group, there was no significant change in the pulmonary function after operation.

경북대학교병원 흉부외과에서 1991년 11월부터 1993년 12월 사이에 원발성 폐질환이 없이 승모판질환으로 승모판치환술을 받은 남자 2례, 여자 10례의 환자에서 술전 및 술후 평균 9개월에 폐기능검사를 실시하였다. 승모판질환의 종류는 승모판협착이 9례, 승모판폐쇄부전이 3례였다. 술전 환자들의 NYHA 기능등급은 3등급이 11례, 4등급이 1례였는데, 술후 평균 9개월이 경과한 시점에서는 10례(83%)에서 1등급으로 호전되어 있었다. 단순흉부 X·선상의 심흉비는 술전의 평균 60.2%에서 술후에는 평균 56.3%로 유의하게 감소되었다. 전체 환자에서의 폐기능검사성적은, 술전 검사에서는 폐활량과 노력성 호기중 간유량이 경도의 감소소견을 보였고, 술후 검사에서는 노력성 호기중간유량과 최대자발성 호흡량이 경도의 감소소견을 보였다. 그러나 술전후의 폐기능검사성적을 비교하였을 때에는 어느 검사항목도 유의한 차이를 보이지 않았다. 한편 술후의 NYHA 기능등급에 의해 환자들을 두 군으로 구분하였을 때, 2등 급군에서는 술후에 유의하게 변화된 폐기능검사항목이 하나도 없었는 반면에, 1등급군에서는 6가지 검사항목에서 유의한 변화가 있었다.

Keywords

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