Departamento de Cirurgia e Anatomia, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Av. Bandeirantes 3.900, São Paulo, SP, Brazil.
Arq Bras Cardiol. 2009 Sep;93(3):290-8. doi: 10.1590/s0066-782x2009000900014.
In our country, the biological valvular prostheses predominate, considering the difficulties related to anticoagulation, even in young patients, in spite of the need for repeated operations due to the degeneration of the bioprostheses.
To report our consecutive series of recipients of isolated St Jude Medical mechanical valve prosthesis in the mitral (MVR) or aortic (AVR) position.
Data from patients operated between January 1995 and December 2003 were revised in order to determine patient survival and prosthesis-related events up to December 2006.
One hundred sixty eight patients had MVR and 117 had AVR. In the MVR cohort, the mean age was 45 years, 75% were 55 years old or younger, and 65% were females. In the ARV cohort, the mean age was 45 years, 66% were 55 years old or younger and 69% were males. Operative mortality for AVR and MVR was 7% and 7.5%, respectively. Freedom from late mortality was 81.8% at 10 years for MVR and 83% for AVR (p=0.752). Freedom from valve-related death at 10 years for the MVR cohort and AVR was 85.6% and 88.7%, respectively (p=0.698). In the MVR cohort, the freedom from reoperation was 97% and 99% in the AVR cohort (p=0.335). Freedom from thromboembolic events was 82% in the MVR cohort and 98% in the AVR cohort (p=0.049). Freedom from bleeding was 71% in the MVR cohort and 86% n the AVR cohort (0.579). Freedom from endocarditis was 98% in the MVR cohort and 99% in the AVR cohort (p=0.534).
This series of predominantly young adult patients undergoing isolated MVR and AVR with the St Jude Medical mechanical prosthesis confirms the good performance of this valve prosthesis in agreement with previous reports.
在我国，生物瓣假体占主导地位，尽管需要因生物瓣假体退化而反复进行手术，但考虑到与抗凝相关的困难，即使是年轻患者也如此。
报告我们连续系列接受单独的史赛克机械瓣膜假体在二尖瓣（MVR）或主动脉瓣（AVR）位置的患者。
回顾 1995 年 1 月至 2003 年 12 月期间接受手术的患者数据，以确定截至 2006 年 12 月的患者生存率和与假体相关的事件。
168 例患者行二尖瓣置换术（MVR），117 例患者行主动脉瓣置换术（AVR）。在 MVR 组中，平均年龄为 45 岁，75%的患者年龄在 55 岁或以下，65%为女性。在 AVR 组中，平均年龄为 45 岁，66%的患者年龄在 55 岁或以下，69%为男性。AVR 和 MVR 的手术死亡率分别为 7%和 7.5%。MVR 的 10 年晚期死亡率无事件生存率为 81.8%，AVR 为 83%（p=0.752）。MVR 组和 AVR 组 10 年瓣膜相关死亡率无事件生存率分别为 85.6%和 88.7%（p=0.698）。MVR 组再手术无事件生存率为 97%，AVR 组为 99%（p=0.335）。MVR 组血栓栓塞事件无事件生存率为 82%，AVR 组为 98%（p=0.049）。MVR 组出血无事件生存率为 71%，AVR 组为 86%（0.579）。MVR 组感染性心内膜炎无事件生存率为 98%，AVR 组为 99%（p=0.534）。
本系列主要为年轻成年患者接受单独的史赛克机械瓣膜假体二尖瓣置换术和主动脉瓣置换术，证实了这种瓣膜假体的良好性能，与先前的报告一致。
