Ohtaki M, Kawashima M, Miki T, Yamaguchi A, Tamura H, Kitamura N
Department of Cardiovascular Surgery, Osaka National Hospital, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1992 Dec;40(12):2131-5.
Between January 1985 and March 1990, isolated valve replacements with the Omnicarbon valve were performed in 90 patients aged 34-72 years. There were 53 aortic valve replacements (AVR) and 37 mitral valve replacements (MVR). The cumulative follow-up was 320 patient-year (py) with a mean follow-up of 3.7 +/- 1.4 years. There were 3 operative and hospital mortalities (3.3%), resulting from retrograde aortic dissection during cardiopulmonary bypass, postoperative renal failure, and rupture of infective pseudoaneurysm in ascending aorta. Seven patients died during the late postoperative period, 4 due to valve-related causes. Two of these patients died of prosthetic valve endocarditis (PVE), while the others died of thromboembolism (including valve thrombosis). The overall actuarial survival rate at 6 years was 86.3% (98.8% for AVR, and 82.1% for MVR). There were 2 thromboembolic events (one mesenteric artery thrombosis, and the other valve thrombosis). The linearized incidence of thromboembolism was 0.63%/py. PVE occurred in 3 patients (0.94%/py). One patient (0.31%/py) was found to have a valve dehiscence due to aortitis syndrome. There were no instances of anticoagulant-related hemorrhage, or valve-related hemolysis. The actuarial rate of freedom from valve-related mortality at 6 years was 93.5% (100% for AVR, and 88.1% for MVR). On the basis of a follow-up period of 6 years, good clinical results and a low incidence of valve-related complications can be demonstrated with Omnicarbon valve.
1985年1月至1990年3月期间,对90例年龄在34至72岁的患者进行了单纯Omnicarbon瓣膜置换术。其中主动脉瓣置换术(AVR)53例,二尖瓣置换术(MVR)37例。累计随访时间为320患者年(py),平均随访时间为3.7±1.4年。有3例手术及住院死亡(3.3%),原因分别为体外循环期间逆行性主动脉夹层、术后肾衰竭以及升主动脉感染性假性动脉瘤破裂。7例患者在术后晚期死亡,4例死于瓣膜相关原因。其中2例死于人工瓣膜心内膜炎(PVE),其他死于血栓栓塞(包括瓣膜血栓形成)。6年时的总体精算生存率为86.3%(AVR为98.8%,MVR为82.1%)。发生了2例血栓栓塞事件(1例肠系膜动脉血栓形成,另1例瓣膜血栓形成)。血栓栓塞的线性发生率为0.63%/py。3例患者发生PVE(0.94%/py)。1例患者(0.31%/py)因主动脉炎综合征出现瓣膜裂开。未发生抗凝相关出血或瓣膜相关溶血事件。6年时免于瓣膜相关死亡的精算率为93.5%(AVR为100%,MVR为88.1%)。基于6年的随访期,Omnicarbon瓣膜可显示出良好的临床效果和较低的瓣膜相关并发症发生率。