Anttila Vesa, Heikkinen Jouni, Biancari Fausto, Oikari Kimmo, Pokela Risto, Lepojärvi Martti, Salmela Esa, Juvonen Tatu
Department of Cardio-thoracic and Vascular Surgery, University of Oulu, Finland.
Scand Cardiovasc J. 2002 Feb;36(1):53-9. doi: 10.1080/140174302317282393.
To compare the long-term clinical outcome of patients who underwent aortic valve replacement with St. Jude Medical and Medtronic-Hall mechanical prostheses.
From June 1978 to June 1982, 43 Medtronic-Hall and 48 St. Jude Medical mechanical valves were implanted in 90 consecutive patients with aortic valve disease, and their clinical outcome was retrospectively assessed.
At 20 years in the St. Jude Medical group and in the Medtronic-Hall group the actuarial rates of overall survival were 50 and 49% (p = NS), of cardiovascular survival 66 and 63% (p = NS), of valve-related survival 95 and 91% (p = NS), of freedom from major valve-related complications 83 and 45% (p = 0.005), from major cerebrovascular events 93 and 71% (p =0.06), from valve thrombosis 97 and 89% (p = NS), from aortic valve reoperation 93 and 88% (p = NS), from major bleeding 96 and 82% (p = 0.04), and from endocarditis 93 and 82% (p = NS), respectively. The linearized rate of overall major aortic valve prosthesis-related complications was 3.47%/year in the Medtronic-Hall valve group and 1.53%/year in the St. Jude Medical valve group (p = 0.003). Multivariate analysis showed that the type of prosthesis was predictive of freedom from valve-related complications (p = 0.01; 2.849; C.I. 95%: 1.246-6.516).
The aortic St. Jude Medical mechanical valve seems to be associated with a slightly lower rate of long-term valve-related morbidity than the aortic Medtronic-Hall mechanical valve. Because of the small patient population and the retrospective nature of the study, the choice between these two prostheses should not be made only on the basis of these findings. However, these results suggest a reappraisal for further comparative studies with such an extended follow-up.
比较接受圣犹达医疗公司（St. Jude Medical）和美敦力 - 霍尔（Medtronic - Hall）机械瓣膜主动脉瓣置换术患者的长期临床结局。
1978年6月至1982年6月，连续90例主动脉瓣疾病患者植入了43枚美敦力 - 霍尔机械瓣膜和48枚圣犹达医疗公司机械瓣膜，并对其临床结局进行回顾性评估。
在圣犹达医疗公司瓣膜组和美敦力 - 霍尔瓣膜组中，20年时总体生存率的精算率分别为50%和49%（p =无显著性差异），心血管生存率为66%和63%（p =无显著性差异），瓣膜相关生存率为95%和91%（p =无显著性差异），无主要瓣膜相关并发症的比例为83%和45%（p = 0.005），无主要脑血管事件的比例为93%和71%（p = 0.06），无瓣膜血栓形成的比例为97%和89%（p =无显著性差异），无需再次进行主动脉瓣手术的比例为93%和88%（p =无显著性差异），无大出血的比例为96%和82%（p = 0.04），无感染性心内膜炎的比例为93%和82%（p =无显著性差异）。美敦力 - 霍尔瓣膜组与主动脉瓣假体相关的总体主要并发症的线性发生率为每年3.47%，圣犹达医疗公司瓣膜组为每年1.53%（p = 0.003）。多变量分析显示，假体类型可预测无瓣膜相关并发症的情况（p = 0.01；2.849；95%置信区间：1.246 - 6.516）。
与美敦力 - 霍尔主动脉机械瓣膜相比，圣犹达医疗公司主动脉机械瓣膜似乎与较低的长期瓣膜相关发病率相关。由于患者数量较少且研究具有回顾性，不应仅基于这些发现来选择这两种假体。然而，这些结果表明需要对进一步的比较研究进行重新评估，并进行更长时间的随访。
