Kawachi Y, Masuda M, Tominaga R, Tokunaga K
Division of Cardiovascular Surgery, Faculty of Medicine Kyushu University, Fukuoka, Japan.
Jpn Circ J. 1991 Jun;55(6):553-62. doi: 10.1253/jcj.55.553.
Comparative long-term performance characteristics of St. Jude Medical (SJM) and bioprosthetic valves were conducted retrospectively for patients who underwent prosthetic valve replacement in the right side of the heart from 1975 to 1988. Fifty-four patients received either SJM (n = 18) or bioprosthetic (n = 37) valves. The cumulative follow-up for SJM valves was 91 valves-years (range 3.9 to 7.2 years) and that for bioprostheses was 282 valve-years (range 1.3 to 14.8 years). Follow-up rate was 100%. The actuarial survival rate excluding hospital deaths at 5 years was 81 +/- 10% for SJM and 97 +/- 3% for bioprosthetic valve recipients (p = ns). The rates of freedom from thrombosis or anticoagulant-related hemorrhage, structural valve failure, prosthetic valve endocarditis, reoperation, and overall valve-related complications at 5 years were 72 +/- 11%, 100%, 100%, 83 +/- 9%, and 72 +/- 11% for SJM valve recipients, and 100%, 97 +/- 3%, 97 +/- 3%, 94 +/- 4%, and 94 +/- 4% for bioprosthetic valve recipients, respectively. Structural valve failure, prosthetic valve endocarditis and reoperations occurred at a similar incidence in each of the two types of prostheses. Thrombosis and overall valve-related events occurred more frequently in SJM valve recipients (5.5 +/- 2.5 vs 0%/valve-year; p less than 0.02, 6.6 +/- 2.7 vs 1.1 +/- 0.6 %/valve-year; p less than 0.03, respectively). The bioprosthetic valve which did not need warfarin anticoagulation therapy had low incidence of valve-related complications and showed good long-term durability even in the younger age group. The bioprosthetic valve was superior to the SJM valve in the right side of the heart.
对1975年至1988年间在心脏右侧接受人工瓣膜置换术的患者进行了圣犹达医疗公司（SJM）瓣膜和生物瓣膜的长期性能特征比较研究。54例患者接受了SJM瓣膜（n = 18）或生物瓣膜（n = 37）置换。SJM瓣膜的累积随访时间为91个瓣膜年（范围3.9至7.2年），生物瓣膜的累积随访时间为282个瓣膜年（范围1.3至14.8年）。随访率为100%。排除住院死亡后，SJM瓣膜置换患者5年的精算生存率为81±10%，生物瓣膜置换患者为97±3%（p = 无显著差异）。SJM瓣膜置换患者5年时无血栓形成或抗凝相关出血、瓣膜结构功能衰竭、人工瓣膜心内膜炎、再次手术及总体瓣膜相关并发症的发生率分别为72±11%、100%、100%、83±9%和72±11%，生物瓣膜置换患者分别为100%、97±3%、97±3%、94±4%和94±4%。两种类型的人工瓣膜中，瓣膜结构功能衰竭、人工瓣膜心内膜炎和再次手术的发生率相似。血栓形成和总体瓣膜相关事件在SJM瓣膜置换患者中更频繁发生（分别为5.5±2.5 vs 0%/瓣膜年；p < 0.02，6.6±2.7 vs 1.1±0.6 %/瓣膜年；p < 0.03）。无需华法林抗凝治疗的生物瓣膜瓣膜相关并发症发生率低，即使在较年轻的年龄组也显示出良好的长期耐久性。在心脏右侧，生物瓣膜优于SJM瓣膜。
