Hayashi K, Nakano H, Sakamoto T, Okamura H
Department of Cardiovascular Surgery, Okamura Memorial Hospital, Shizuoka, Japan.
Kyobu Geka. 2000 Jan;53(1):79-82.
A 53-year-old female had undergone mitral valve replacement with Carpentier-Edwards (C-E) porcine bioprosthesis for mitral valve regurgitation at the other hospital in November, 1981. Postoperative clinical course was uneventful, since she was referred from the other hospital in 1990. In December, 1997, she had sudden complaint of shortness of breath on effort, and the chest X-ray showed pulmonary congestion and increase of cardio-thoracic ratio. Echocardiography and catheterization revealed severe mitral regurgitation due to bioprosthesis malfunction and aortic valve regurgitation. Combined mitral and aortic valve replacement was successfully performed with mechanical valves in February, 1998. The explanted C-E porcine bioprosthesis showed the commissural dehiscence from only one of the three stents without any leaflet perforation, commissural tear, pannus overgrowth, impaired leaflet mobility and leaflet deterioration or calcification. This case suggested the variety of malfunction of C-E porcine bioprosthesis and the limitation of its long-term durability.
一名53岁女性于1981年11月在另一家医院因二尖瓣反流接受了使用Carpentier-Edwards(C-E)猪生物瓣膜的二尖瓣置换术。术后临床过程平稳,自1990年从另一家医院转诊而来。1997年12月,她突然出现劳力性呼吸急促,胸部X线显示肺淤血且心胸比率增加。超声心动图和心导管检查显示由于生物瓣膜功能障碍导致严重二尖瓣反流以及主动脉瓣反流。1998年2月成功进行了二尖瓣和主动脉瓣联合置换术,使用的是机械瓣膜。取出的C-E猪生物瓣膜显示三个支架中只有一个出现瓣叶连合处裂开,没有任何瓣叶穿孔、瓣叶连合处撕裂、血管翳过度生长、瓣叶活动受限以及瓣叶退化或钙化。该病例提示了C-E猪生物瓣膜功能障碍的多样性及其长期耐久性的局限性。