Smithwick W, Kouchoukos N T, Karp R B, Pacifico A D, Kirklin J W
Ann Thorac Surg. 1975 Sep;20(3):249-55. doi: 10.1016/s0003-4975(10)64216-6.
During a two-year period (August, 1971, to July, 1973) 1 Starr-Edwards Model 2400 and 135 Starr-Edwards Model 2320 aortic prostheses were inserted without postoperative antiocagulant therapy. Seven of these valves (including the Model 2400 prosthesis) have been replaced because of substantial transvalvular gradients resulting from fibrous overgrowth of the valve orifice. Symptoms associated with aortic stenosis occurred an average of nine months after the initial operation. Six patients had severe anemia (packed cell volume less than 30%) and hemolysis (serum lactic dehydrogenase greater than 900 units). Gradients across the prostheses ranged from 66 to 105 mm Hg with a mean of 87 mm Hg. One valve was size 8A, 3 were 10A, and 1 was 12A. Fibrous ingrowth was not observed in an earlier group of 23 patients receiving the Model 2310 or Model 2320 prosthesis who were placed on long-term anticoagulant therapy. These findings, coupled with a 9% incidence of thromboembolism at one year, indicate that patients having these prostheses inserted should receive long-term anticoagulant therapy.
在两年期间（1971年8月至1973年7月），在未进行术后抗凝治疗的情况下植入了1个斯塔尔-爱德华兹2400型和135个斯塔尔-爱德华兹2320型主动脉瓣膜假体。其中7个瓣膜（包括2400型假体）因瓣膜口纤维组织过度生长导致明显的跨瓣膜压差而被置换。与主动脉瓣狭窄相关的症状平均在初次手术后9个月出现。6例患者出现严重贫血（红细胞压积小于30%）和溶血（血清乳酸脱氢酶大于900单位）。假体的压差范围为66至105毫米汞柱，平均为87毫米汞柱。1个瓣膜尺寸为8A，3个为10A，1个为12A。在较早一组接受2310型或2320型假体并接受长期抗凝治疗的23例患者中未观察到纤维组织长入。这些发现，再加上一年时9%的血栓栓塞发生率，表明植入这些假体的患者应接受长期抗凝治疗。
