Roe B B, Fishman N H, Hutchinson J C, Goodenough S H
Ann Thorac Surg. 1975 Sep;20(3):256-64. doi: 10.1016/s0003-4975(10)64217-8.
Total detachment and embolization of the hinged, tilting occluder of the Wada-Cutter prosthetic heart valve was the proved cause of death in 2 of 25 patients who had these devices implanted at the University of California, San Francisco, Medical Center in 1969-70. In addition, there were 8 late deaths without postmortem examination, 2 of which were sudden and 4 of which followed rapidly progressive congestive heart failure over a period of hours to days. Prosthetic malfunction appears to be a possible mechanism of death in the majority of these patients. The 2 additional late deaths were unrelated to valve malfunction. Regurgitant murmurs have been identified during follow-up examination in 17 patients. Two patients had prosthetic replacement for hemodynamically significant leaks through the valve mechanism and were found to have no perivalvular leak. Six additional patients had prophylactic replacement of the Wada-Cutter valve. Measurements on 7 available occluders that were removed showed variable degrees of material movement at the hinge. This experience has caused us to recommend elective replacement of remaining Wada-Cutter valves.
1969年至1970年期间，在加利福尼亚大学旧金山分校医学中心植入Wada-Cutter人工心脏瓣膜的25名患者中，有2名患者经证实因铰链式可倾斜封堵器完全脱离和栓塞而死亡。此外，有8例晚期死亡病例未进行尸检，其中2例猝死，4例在数小时至数天内迅速发展为进行性充血性心力衰竭。人工瓣膜功能障碍似乎是这些患者中大多数死亡的可能机制。另外2例晚期死亡与瓣膜功能障碍无关。在随访检查中，17例患者发现有反流性杂音。2例患者因瓣膜机制存在血流动力学显著渗漏而进行了人工瓣膜置换，未发现瓣周漏。另外6例患者接受了Wada-Cutter瓣膜的预防性置换。对7个取出的可用封堵器进行的测量显示，铰链处材料移动程度各不相同。这段经历促使我们建议对剩余的Wada-Cutter瓣膜进行择期置换。
