Miura Y, Miyairi T, Kitamura T, Kigawa I, Fukuda S
Department of Cardiovascular Surgery, Mitsui Memorial Hospital, Tokyo, Japan.
Kyobu Geka. 2006 Apr;59(4):306-12.
We studied cardiac function, clinical outcome and quality of life (QOL) long after aortic valve replacement for pure aortic stenosis. Forty-four patients in small group [St. Jude Medical (SJM) 17 HP, 19 A], and 69 patients in non-small group (19 HP, 21 A, 23 A) operated on from 1984 to 2004 were enrolled in this study. We assessed the clinical data, aortic pressure gradient, left ventricular mass index (LVMI), and ejection fraction (EF) by preoperative and postoperative echocardiography. Moreover to evaluate QOL after the operation, we performed SF-36 used for the evaluation of health and QOL worldwide. Mean follow-up is 7.1 +/- 4.8 years in small group, and 6.8 +/- 4.6 years in non-small group. There were 2 hospital deaths in small group, and 1 in non-small group. The actual survival rate at 10-year were 89.2% in small group, and 85.6% in non-small group. There was no significant difference in hospital mortality, LVMI, long-term survival rate, and the scores of SF-36 between the 2 groups. The use of small sized prosthetic valves in patients with small aortic annulus might be justified when there is no patient-prosthesis mismatch.
我们研究了单纯主动脉瓣狭窄患者行主动脉瓣置换术后很长一段时间的心脏功能、临床结局和生活质量（QOL）。本研究纳入了1984年至2004年期间接受手术的44例小尺寸组患者[圣犹达医疗公司（SJM）17例高性能瓣膜，19例标准瓣膜]和69例非小尺寸组患者（19例高性能瓣膜，21例标准瓣膜，23例其他瓣膜）。我们通过术前和术后超声心动图评估临床数据、主动脉压力阶差、左心室质量指数（LVMI）和射血分数（EF）。此外，为了评估术后的生活质量，我们采用了用于全球健康和生活质量评估的SF-36量表。小尺寸组的平均随访时间为7.1±4.8年，非小尺寸组为6.8±4.6年。小尺寸组有2例住院死亡，非小尺寸组有1例。小尺寸组10年实际生存率为89.2%，非小尺寸组为85.6%。两组之间在住院死亡率、LVMI、长期生存率和SF-36评分方面无显著差异。当不存在人工瓣膜-患者不匹配时，在主动脉瓣环较小的患者中使用小尺寸人工瓣膜可能是合理的。
