索林碳酸氢盐心脏瓣膜假体治疗风湿性疾病的中期经验。

Erdil N, Cetin L, Ates S, Demirkilic U, Sener E, Tatar H, Cakir B

Department of Cardiovascular Surgery, Inonu University, Turgut Ozal Medical Center, Malatya, Turkey.

J Cardiovasc Surg (Torino). 2003 Oct;44(5):597-603.

BACKGROUND

In this study, we present a single center experience with Bicarbon bileaflet valve in 307 patients with rheumatic heart disease.

METHODS

Between August 1998 and September 2000, 307 patients underwent heart valve replacement using the Bicarbon bileaflet valve (Sorin Biomedica, Saluggia, Italy) with an average age of 47.19+/-13.21 years (range 14 to 80 years), consisting of 147 males and 160 females at Alkan Hospital, Cardiovascular Surgery Department. Aortic valve replacement (AVR) was performed in 77 patients, mitral valve replacement (MVR) in 156 patients and double valve replacement (DVR) in 74 patients.

RESULTS

The early mortality rate was 3.3% (10/307) and there was no late mortality. The actuarial survival rate, including hospital mortality, was 96.74+/-1.01% for the whole group, 96.5+/-1.5% for the MVR group, 97.4+/-1.8% for the AVR group and 97.3+/-1.9% for the DVR group at 35 months. One patient had obstructive valve thrombosis with MVR. The 35 months actuarial freedom from valve thrombosis was 99.58+/-0.4% for the whole group. Four patients were reoperated and the 35 months actuarial freedom from reoperation was 98.53+/-0.7% for the whole group, 98.65+/-0.9% for the MVR group, 96.73+/-02% for the DVR group and 100% for the AVR group. No instances of perivalvular leak, hemolysis, endocarditis or embolism were observed during the entire follow-up period. Mean follow-up duration was 16.5+/-7.9 months (ranged 4 to 35 months).

CONCLUSION

We have presented our mid-term results with the Sorin Bicarbon bileaflet valve in patients with rheumatic heart disease, which provided good clinical performance combined with meticulous patient care and advanced surgical techniques.

背景

在本研究中，我们介绍了在307例风湿性心脏病患者中使用双叶碳酸氢盐瓣膜的单中心经验。

方法

1998年8月至2000年9月期间，307例患者在阿尔坎医院心血管外科接受了使用双叶碳酸氢盐瓣膜（索林生物医学公司，意大利萨卢贾）的心脏瓣膜置换术，平均年龄为47.19±13.21岁（范围14至80岁），其中男性147例，女性160例。77例患者进行了主动脉瓣置换术（AVR），156例患者进行了二尖瓣置换术（MVR），74例患者进行了双瓣膜置换术（DVR）。

结果

早期死亡率为3.3%（10/307），无晚期死亡。包括医院死亡率在内的全组35个月精算生存率为96.74±1.01%，MVR组为96.5±1.5%，AVR组为97.4±1.8%，DVR组为97.3±1.9%。1例MVR患者发生瓣膜阻塞性血栓形成。全组35个月无瓣膜血栓形成的精算自由度为99.58±0.4%。4例患者接受了再次手术，全组35个月无再次手术的精算自由度为98.53±0.7%，MVR组为98.65±0.9%，DVR组为96.73±0.2%，AVR组为100%。在整个随访期间未观察到瓣周漏、溶血、心内膜炎或栓塞的情况。平均随访时间为16.5±7.9个月（范围4至35个月）。