Kafsi N, Trabelsi S, Acar P, Ben Ismail M
Service des maladies cardiovasculaires, hôpital la Rabta, Tunis, Tunisie.
Arch Mal Coeur Vaiss. 1991 Nov;84(11):1523-7.
Two groups of patients having undergone mitral valve replacement with a Starr-Edwards (Group A = 149 patients) or Saint Jude (Group B = 87 patients) prosthesis between 1981 and 1987 were included in this study. The aim of the study was to evaluate and compare the mortality, the morbidity--especially with respect to thromboembolic events--and echo Doppler haemodynamic profiles of the two types of prosthesis. The two patient groups were comparable with respect to age, aetiology and preoperative haemodynamic status. Late mortality was greater in Group A (13% versus 4.5%) and the 5 year survival was significantly better in Group B (95% versus 89%). Thromboembolic events were significantly more common in Group A (2.6% per patient year versus 0.5% per patient year in Group B, p = 0.01). Five years survival without thromboembolic event was 94% in Group B versus 86% in Group A. The haemodynamic Doppler echocardiography profiles were compared on random samples of 30 cases from each group, the only exclusion criterion being suspected or confirmed prosthetic valve dysfunction.
本研究纳入了1981年至1987年间接受Starr-Edwards人工瓣膜置换术的两组患者（A组 = 149例患者）和接受圣犹达人工瓣膜置换术的患者（B组 = 87例患者）。本研究的目的是评估和比较两种人工瓣膜的死亡率、发病率——尤其是血栓栓塞事件方面——以及超声多普勒血流动力学特征。两组患者在年龄、病因和术前血流动力学状态方面具有可比性。A组的晚期死亡率更高（13% 对 4.5%），B组的5年生存率显著更高（95% 对 89%）。血栓栓塞事件在A组明显更常见（每年每位患者2.6% 对B组每年每位患者0.5%，p = 0.01）。无血栓栓塞事件的5年生存率在B组为94%，在A组为86%。对每组30例随机样本进行了血流动力学多普勒超声心动图特征比较，唯一的排除标准是怀疑或确诊人工瓣膜功能障碍。
