[Clinical and morphologic classification of valve replacement with giant heart]

From Apr. 1977 to Dec. 1992, 285 patients with giant heart (CTR > 0.70) underwent valve replacement. According to the index of cardiac chamber enlargement, the patients were clinically and morphologically classified in to four types. Type of left atrium (153 cases, 56.3%) is most common and has good surgical result. The operative mortality was reduced from 11.1% to 1.3%. Type of left ventricle (42, 15.2%) was high risk for surgical treatment, the operative mortality was 33.3%. Type of right cardiac enlargement (17 cases) is less common than other types, and is mainly for tricuspid valve incompetence. Type of total cardiac enlargement was found in 60 cases (22.1%), it was conventionally complicated with the disfunction of other organs with a higher operative mortality of 23.3%. We conclude that this classification represents the degree of cardiac chamber enlargement and the severity of heart disfunction, and has good coincidence with surgical result. It is helpful to identifying operative candidate for valve replacement with giant heart.