目的 总结≥80岁高龄患者心脏瓣膜置换手术的临床效果及围手术期治疗经验。方法 56例≥80岁高龄患者于体外循环中度低温下行心脏瓣膜置换手术，分析其手术情况、并发症情况和随访情况。结果 56例患者中，4例术后早期死亡，52例（92.9%）康复出院。术后发生并发症23例，主要为呼吸功能不全、肾功能不全、恶性心律失常、胸腔积液及心包积液等。42例患者随访时间超过2年。术后2年，患者心功能分级Ⅱ级31例，Ⅲ级11例；左心房内径和肺动脉压均显著小于术前（P<0.05）。结论 选择合适的手术时机、加强围手术期处理可使≥80岁高龄患者行心脏瓣膜置换手术具有可行性。

Objective To summarize the clinical outcomes and experience in perioperative management in octogenarians undergoing cardiac valve replacement. Methods Fifty-six octogenarians underwent heart valve replacement with hypothermia and cardiopulmonary bypass, and the surgical outcomes, complications and followup findings were analyzed. Results Among the 56 patients, 4 died early after operation, and 52 (92.9%) discharged. There were 23 cases of complications, including respiratory failure, renal failure, ventricular arrhythmia, pleural effusion and pericardial effusion. Forty-two patients were followed up for more than 2 years, there were 31 patients with gradeⅡ of cardiac function and 11 patients with grade Ⅲ of cardiac function 2 years after operation, and the left atrial diameter was significantly smaller and the pulmonary arterial pressure was significantly lower 2 years after operation than those before operation (P<0.05). Conclusion With appropriate timing of operation and proper perioperative management, cardiac valve replacement may be feasible for octogenarians with cardiac valvular

disease.