Bortolotti U, Milano A, Guerra F, Mazzucco A, Mossuto E, Thiene G, Gallucci V
Department of Cardiovascular Surgery, University of Padova Medical School, Italy.
Ann Thorac Surg. 1991 Mar;51(3):430-7. doi: 10.1016/0003-4975(91)90859-o.
The incidence of major valve-related complications was evaluated in a series of patients in whom the Hancock pericardial xenograft was used for aortic (AVR; n = 84), mitral (MVR; n = 17) and mitral-aortic (MAVR; n = 13) valve replacement. At 7 years actuarial survival is 66% +/- 8% after AVR, 64% +/- 13% after MVR, and 41% +/- 15% after MAVR, whereas actuarial freedom from valve-related death is 79% +/- 7% after AVR, 78% +/- 13% after MVR, and 81% +/- 12% after MAVR. Actuarial freedom from thromboemboli and anticoagulant-related hemorrhage at 7 years is 93% +/- 4% and 98% +/- 2% after AVR and 83% +/- 10% and 88% +/- 11% after MVR; no such complications occurred after MAVR. Structural valve deterioration determined at reoperation, at autopsy, or by clinical investigation was observed in 34 patients with AVR (10.0 +/- 0.2%/patient-year), in 10 with MVR (10.6 +/- 3.3%/patient-year), and in 9 with MAVR (16.6 +/- 5.5%/patient-year). After AVR, 19 patients underwent reoperation and 2 died before reoperation; 4 patients with MVR underwent reoperation, and 7 patients with MAVR underwent reoperation and 1 died before reoperation. Seventy-eight percent of the current survivors (13 patients with AVR, 7 with MVR, and 1 with MAVR) have clinical evidence of valve failure. At 7 years actuarial freedom from structural deterioration of the Hancock pericardial xenograft is 25% +/- 7% after AVR, 29% +/- 14% after MVR, and 0% after MAVR.(ABSTRACT TRUNCATED AT 250 WORDS)
在一系列使用汉考克心包异种移植物进行主动脉瓣置换术（AVR；n = 84）、二尖瓣置换术（MVR；n = 17）和二尖瓣 - 主动脉瓣置换术（MAVR；n = 13）的患者中，评估了主要瓣膜相关并发症的发生率。7年时，AVR术后精算生存率为66%±8%，MVR术后为64%±13%，MAVR术后为41%±15%；而AVR术后瓣膜相关死亡的精算无事件生存率为79%±7%，MVR术后为78%±13%，MAVR术后为81%±12%。7年时，AVR术后血栓栓塞和抗凝相关出血的精算无事件生存率分别为93%±4%和98%±2%，MVR术后分别为83%±10%和88%±11%；MAVR术后未发生此类并发症。在34例AVR患者（10.0±0.2%/患者年）、10例MVR患者（10.6±3.3%/患者年）和9例MAVR患者（16.6±5.5%/患者年）中观察到通过再次手术、尸检或临床调查确定的瓣膜结构恶化。AVR术后，19例患者接受了再次手术，2例在再次手术前死亡；4例MVR患者接受了再次手术，7例MAVR患者接受了再次手术，1例在再次手术前死亡。目前存活患者中的78%（13例AVR患者、7例MVR患者和1例MAVR患者）有瓣膜功能衰竭的临床证据。7年时，AVR术后汉考克心包异种移植物结构恶化的精算无事件生存率为25%±7%，MVR术后为29%±14%，MAVR术后为0%。（摘要截断于250字）
