Edmiston W A, Harrison E C, Duick G F, Parnassus W, Lau F Y
Am J Cardiol. 1978 Mar;41(3):508-11. doi: 10.1016/0002-9149(78)90007-3.
A low incidence rate of thromboembolism has been reported in mitral porcine valve recipients. In contrast, 5 of 22 single mitral porcine valve recipients (23 percent) followed up in our clinic for a mean of 16 months had thromboembolic events. All patients but one were receiving long-term anticoagulant therapy. One thromboembolic event resulted in death, three in permanent neurologic deficits and one in a peripheral arterial occlusion. All five patients with emboli had atrial fibrillation and left atrial enlargement. Three had thromboembolic events before porcine heart valve implantation. In addition, five mitral porcine valve recipients who were not receiving anticoagulant therapy were examined at autopsy. Thrombus was identified in the left atrium in three patients, at the tissue-valve interface (sewing ring) in two, on the porcine valve cusps in one and in the right atrium in one. Factors influencing thrombus formation such as left atrial enlargement, atrial fibrillation and a prosthetic device are present after mitral porcine valve implantation and are indications for long-term anticoagulation therapy.
据报道，二尖瓣猪瓣膜置换患者的血栓栓塞发生率较低。相比之下，在我们诊所接受随访的22名单纯二尖瓣猪瓣膜置换患者中，有5例（23%）在平均16个月的随访期内发生了血栓栓塞事件。除1例患者外，所有患者均接受长期抗凝治疗。1例血栓栓塞事件导致死亡，3例导致永久性神经功能缺损，1例导致外周动脉闭塞。所有5例发生栓塞的患者均有房颤和左心房扩大。其中3例在猪心脏瓣膜植入前就发生过血栓栓塞事件。此外，对5例未接受抗凝治疗的二尖瓣猪瓣膜置换患者进行了尸检。3例患者在左心房发现血栓，2例在组织-瓣膜界面（缝合环）发现血栓，1例在猪瓣膜瓣叶发现血栓，1例在右心房发现血栓。二尖瓣猪瓣膜置换术后存在影响血栓形成的因素，如左心房扩大、房颤和人工瓣膜装置，这些都是长期抗凝治疗的指征。
