植入 Hancock II 猪瓣 25 年后的患者结局。

The fate of Hancock II porcine valve recipients 25 years after implant.

机构信息

Cardiovascular Surgery Department, Cà Foncello Hospital, Treviso, Italy.

出版信息

Eur J Cardiothorac Surg. 2010 Aug;38(2):141-6. doi: 10.1016/j.ejcts.2010.01.046. Epub 2010 Mar 2.

DOI:10.1016/j.ejcts.2010.01.046

PMID:20194029

Abstract

OBJECTIVE

The Hancock II (HII) is a second-generation porcine bioprosthesis introduced into clinical use in 1982. This study aimed to evaluate very long-term outcomes for the HII valve in a large patient population.

METHODS

Between May 1983 and November 1993, 517 consecutive patients (pts) (309 male, mean age: 64+/-9 years) underwent valve replacement (VR) surgery with HII, with 302 (58.4%) in the aortic VR (AVR) and 215 (41.6%) in the mitral VR (MVR) position, respectively. At implant, 106 pts (20.5%) were <60 years of age (G1), while 411 (79.5%) were > or =60 years of age (G2). The 25-year follow-up was complete for all pts at a median of 12 years (range: 0-25).

RESULTS

Long-term death occurred in 208 AVR and in 165 MVR pts. Survival at 15 and 20 years was 39.5% and 23.3% in AVR pts and 39.0% and 15.8% in MVR pts. At 25 years the survival of MVR pts was 13.7% (four pts at risk). Late freedom from re-operation was 85.5% and 79.3% at 15 and 20 years in the AVR pts and 73.3% and 52.8% in the MVR pts, respectively. In the AVR population, 20-year freedom from re-operation was 52.2% in G1 pts and 86.8% in G2 pts (p<0.0001), while in the MVR population it was 41.4% in G1 pts and 61.9% in G2 pts (p=0.201), respectively.

CONCLUSIONS

These results confirm the excellent long-term performance of the HII bioprosthesis.

摘要

目的

Hancock II（HII）是一种第二代猪生物瓣，于 1982 年投入临床使用。本研究旨在评估该瓣膜在大量患者人群中的长期效果。

方法

1983 年 5 月至 1993 年 11 月，517 例连续患者（pts）（309 例男性，平均年龄：64+/-9 岁）接受了 HII 瓣膜置换术（VR），其中 302 例（58.4%）为主动脉 VR（AVR），215 例（41.6%）为二尖瓣 VR（MVR）。植入时，106 例（20.5%）<60 岁（G1），411 例（79.5%）≥60 岁（G2）。所有患者中位随访 12 年（0-25 年），随访率为 100%。

结果

208 例 AVR 和 165 例 MVR 患者发生长期死亡。AVR 患者 15 年和 20 年生存率分别为 39.5%和 23.3%，MVR 患者分别为 39.0%和 15.8%。25 年时，MVR 患者的生存率为 13.7%（4 人处于风险中）。AVR 患者 15 年和 20 年的免于再次手术的晚期生存率分别为 85.5%和 79.3%，MVR 患者分别为 73.3%和 52.8%。在 AVR 人群中，G1 患者的 20 年免于再次手术的生存率为 52.2%，G2 患者为 86.8%（p<0.0001），而在 MVR 人群中，G1 患者为 41.4%，G2 患者为 61.9%（p=0.201）。