Jegaden O, Pouyau A, Montagna P, Delaye J, Mikaeloff P
Service de Chirurgie cardio-vasculaire, Hôpital cardiologique, Lyon.
Ann Cardiol Angeiol (Paris). 1991 Feb;40(2):61-8.
Between 1970 and 1984, 386 mitral valve replacements with the SE 6120 prosthesis were performed with a mean post-operative follow-up of 75 +/- 44 months or a total follow-up of 2520 patient years (PY). Rapid post-operative mortality was 6.7 percent and the delayed mortality 26.5 percent, the 5-year actuarial survival rate was 80 +/- 2% and that at 10 years 67 +/- 2% (including early mortality). There was no significant difference for survival between single-valve replacements (n = 183) and multiple-valve replacements (n = 203). Multifactorial prognosis analysis (Cox) gave two post-operative prognosis: X (n = 386) = 0.0391 (age) + 0.2421 (NYHA stage); Y (n = 147) = 0.8561 (X) + 0.6299 (VG type). The incidence of complications related to the prosthesis is 4.16 per 100 PY, including sudden deaths. The current actuarial analysis shows that at 5 years 91 +/- 1% at 10 years 78 +/- 2% of the operated subjects are devoid of any such complication and of thrombosis of the valve. Statistically, it was found that permanent atrial fibrillation (p = 0.03), the size of the right atrium (p = 0.02) played a promoting role. With a post-operative follow-up in excess of 8 years. 79% of the survivors are symptom-free or present few symptoms and the myocardial response is poor in 52 patients (NYHA stage III or IV).
1970年至1984年间，采用SE 6120人工瓣膜进行了386例二尖瓣置换术，术后平均随访75±44个月，或总计随访2520患者年（PY）。术后早期死亡率为6.7%，延迟死亡率为26.5%，5年精算生存率为80±2%，10年精算生存率为67±2%（包括早期死亡率）。单瓣膜置换术（n = 183）和多瓣膜置换术（n = 203）之间的生存率无显著差异。多因素预后分析（Cox模型）得出两个术后预后指标：X（n = 386）= 0.0391（年龄）+ 0.2421（纽约心脏病协会分级）；Y（n = 147）= 0.8561（X）+ 0.6299（瓣膜类型）。与人工瓣膜相关的并发症发生率为每100 PY 4.16例，包括猝死。目前的精算分析表明，术后5年91±1%、10年78±2%的手术患者无任何此类并发症及瓣膜血栓形成。经统计学分析发现，永久性心房颤动（p = 0.03）、右心房大小（p = 0.02）起促进作用。术后随访超过8年。79%的幸存者无症状或症状轻微，52例患者心肌反应较差（纽约心脏病协会III或IV级）。
