[Gynecologic operations on patients with valvular heart disease or after cardiac valvular replacement surgery]

For patients with valvular heart disease or after cardiac valvular replacement surgery, the indication of gynecologic operations are remains undefine. We investigated 23 patients who undergoing gynecologic operations with valvular heart disease or after cardiac valvular replacement surgery. The current studies suggest that (1) general gynecologic operations can be performed on patients with valvular heart disease or mild cardiac dysfunction (New York Heart Association, NYHA, classification I-II) under carefully cardiovascular monitoring. (2) gynecologic operations should be done early on patients with giant gynecologic tumor which suggest malignancy and mild cardiac dysfunction (NYHA I-III). (3) on patients with repeated vaginal bleeding and anemia which induced heart failure, gynecologic operations should be performed immediately after cardiac function recovery. (4) on patients who have had mechanical cardiac valvular replacement, anticoagulant therapy should be stopped at 48 hours before gynecologic operations, and resumed at 48 hours after operations to avoid thromboembolism.