Kimura Michio, Iwakuma Akio, Morishige Noritsugu, Nakamura Katsuhiko, Tachikawa Yutaka, Shibano Ryuichi, Iwahashi Hidehiko, Zaitsu Ryuji, Motomura Tadashi, Takeuchi Kazuma, Tashiro Tadashi, Kitasato Katsushi
Department of Cardiovascular Surgery, Fukuoka University School of Medicine, Kasuya Fukuoka, Japan.
Artif Organs. 2003 Aug;27(8):706-13. doi: 10.1046/j.1525-1594.2003.06963.x.
From May 1976 to June 2001, 95 porcine heart valve bioprostheses (BPs) were explanted. Among them, 85 prostheses were available for an analysis of structural valve deterioration (SVD). There were 32 Hancock (H) BPs and 53 Carpentier-Edwards (CE) BPs, with a mean implantation duration of 12 +/- 3.5 and 11.0 +/- 4 years, respectively. There were two extraordinary complications. One was commissural dehiscence (CD) of the CEBPs in 10/53 cases (18.9%), with a mean duration of 12.7 +/- 2.7 years. This was not observed in the HBPs. The other was pannus formation in both BPs. In the mitral position, it was 25/32 (78.1%) in HBPs and 37/53 (69.8%) in CEBPs. In the aortic position, it was 4/32 (1.3%) in the HBPs and 11/53 (20.8%) in the CEBPs. We conclude that CD could not be diagnosed preoperatively and anticoagulation is therefore indicated to prevent pannus formation of such prostheses, particularly in those located in the mitral position.
1976年5月至2001年6月期间，共取出95个猪心脏瓣膜生物假体（BP）。其中，85个假体可用于分析瓣膜结构退变（SVD）。有32个Hancock（H）BP和53个Carpentier-Edwards（CE）BP，平均植入时间分别为12±3.5年和11.0±4年。出现了两种特殊并发症。一种是CEBP的瓣叶开裂（CD），在53例中有10例（18.9%）出现，平均时间为12.7±2.7年。HBP未观察到这种情况。另一种是两种BP均出现了血管翳形成。在二尖瓣位置，HBP为25/32（78.1%），CEBP为37/53（69.8%）。在主动脉位置，HBP为4/32（1.3%），CEBP为11/53（20.8%）。我们得出结论，CD术前无法诊断，因此建议进行抗凝以防止此类假体形成血管翳，特别是位于二尖瓣位置的假体。
