Ayegnon Kouakou Gregoire, Aupart Michel, Bourguignon Thierry, Mirza Alain, May Marc-Antoine, Marchand Michel
Department of Cardiovascular and Thoracic Surgery, Hospital University of Tours, Tours, France.
Asian Cardiovasc Thorac Ann. 2011 Feb;19(1):14-9. doi: 10.1177/0218492310395422.
Data of 401 patients who underwent mitral valve replacement with the Carpentier-Edwards Perimount bioprosthesis between 1984 and 2009 were evaluated. Their mean age was 68.1 ± 10.4 years (range, 22-90 years) and 54.9% were female. The most common etiology was degenerative disease (33.2%) and 62.1% of patients had mitral insufficiency. Follow-up was 3,178 patient-years, and 96.8% complete; the mean follow-up was 8.9 ± 3.1 years. Overall survival at 25 years was 10.2% ± 3%. Late mortality was 2.48% per patient-year, and valve-related deaths occurred at 1.62% per patient-year. The actuarial freedom from reoperation due to structural valve deterioration at 20 years was 24.3% ± 2% for degenerative disease and 15% ± 1.4% for non-degenerative disease. For degenerative valve disease, the freedom from structural valve deterioration at 18-years was 39% ± 1% for recipients <60-years old and 66% ± 2% for those ≥60-years old. Our data confirm the excellent durability and low mortality associated with the Carpentier-Edwards Perimount for mitral valve replacement. The rate of calcification of the valve was unrelated to degenerative valve disease, but our findings suggest that this prosthesis gives better results in recipients ≥60-years old than in younger patients.
对1984年至2009年间接受Carpentier-Edwards Perimount生物瓣膜二尖瓣置换术的401例患者的数据进行了评估。他们的平均年龄为68.1±10.4岁(范围22 - 90岁),女性占54.9%。最常见的病因是退行性疾病(33.2%),62.1%的患者患有二尖瓣关闭不全。随访时间为3178患者年,随访完整率为96.8%;平均随访时间为8.9±3.1年。25年时的总生存率为10.2%±3%。晚期死亡率为每年2.48%,瓣膜相关死亡发生率为每年1.62%。因瓣膜结构恶化需要再次手术的20年预期免再手术率,退行性疾病患者为24.3%±2%,非退行性疾病患者为15%±1.4%。对于退行性瓣膜疾病,18年时<60岁接受者瓣膜结构恶化的免再手术率为39%±1%,≥60岁接受者为66%±2%。我们的数据证实了Carpentier-Edwards Perimount二尖瓣置换术具有出色的耐久性和低死亡率。瓣膜钙化率与退行性瓣膜疾病无关,但我们的研究结果表明,该人工瓣膜在≥60岁接受者中比年轻患者效果更好。