Klinik für Herz- und Gefässchirurgie, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Arnold-Heller-Strasse 7, Kiel, Germany.
Dtsch Arztebl Int. 2008 Feb;105(8):143-8. doi: 10.3238/arztebl.2008.0143. Epub 2008 Feb 22.
The choice of type of heart valve prosthesis is determined by the patient's age since bioprostheses have a limited lifespan. This article reviews current recommendations and the literature on cardiac valve replacement.
Selective literature search in Medline/PubMed back to 1996 and review of current national and international recommendations from specialist societies.
The recommendations guiding the type of heart valve replacement have been revised in recent years. Of particular interest are the new generation of biological prostheses with extended durability, a growing use of stentless bioprostheses, a decrease in mortality of reoperation and an increase in life expectancy. Comorbidities such as chronic renal insufficiency or chronic atrial fibrillation are no longer contraindications to bioprosthesis. The number of heart valve replacements in recent years rose despite a concomitant increase in valve repairs. Aortic valves are being increasingly replaced by bioprostheses.
The choice of heart valve prosthesis should be tailored to each patient taking into account the patient's age, life expectancy, comorbidities, and life style. Different decisions may be made now than those based on earlier recommendations resulting in an individualized treatment, in patients over the age of 65 or 70.
心脏瓣膜假体类型的选择取决于患者的年龄，因为生物假体的使用寿命有限。本文回顾了心脏瓣膜置换的当前建议和文献。
选择性地在 Medline/PubMed 上回溯至 1996 年的文献检索，并对来自专业协会的当前国家和国际建议进行综述。
近年来，指导心脏瓣膜置换类型的建议已经修订。特别值得关注的是具有延长耐久性的新一代生物假体、越来越多地使用无支架生物假体、手术死亡率降低以及预期寿命延长。慢性肾功能不全或慢性心房颤动等合并症不再是生物假体的禁忌症。尽管瓣膜修复同时增加，但近年来心脏瓣膜置换的数量有所增加。生物假体越来越多地用于替换主动脉瓣。
应根据患者的年龄、预期寿命、合并症和生活方式，为每位患者量身选择心脏瓣膜假体。现在可能会做出不同于早期建议的决定，从而为 65 岁或 70 岁以上的患者提供个体化治疗。
