Galiñanes Manuel, Meduoye Ayo, Ferreira Ignacio, Sosnowski Andrzej
Department of Cardiac Surgery, The Glenfield Hospital, Leicester, UK.
J Cardiothorac Surg. 2011 Jun 23;6:86. doi: 10.1186/1749-8090-6-86.
To retrospectively analyze the clinical outcome of a totally biological composite stentless aortic valved conduit (No-React® BioConduit) implanted using the Bentall procedure over ten years in a single centre.
Between 27/10/99 and 19/01/08, the No-React® BioConduit composite graft was implanted in 67 patients. Data on these patients were collected from the in-hospital database, from patient notes and from questionnaires. A cohort of patients had 2D-echocardiogram with an average of 4.3 ± 0.45 years post-operatively to evaluate valve function, calcification, and the diameter of the conduit.
Implantation in 67 patients represented a follow-up of 371.3 patient-year. Males were 60% of the operated population, with a mean age of 67.9 ± 1.3 years (range 34.1-83.8 years), 21 of them below the age of 65. After a mean follow-up of 7.1 ± 0.3 years (range of 2.2-10.5 years), more than 50% of the survivors were in NYHA I/II and more than 60% of the survivors were angina-free (CCS 0). The overall 10-year survival following replacement of the aortic valve and root was 51%. During this period, 88% of patients were free from valved-conduit related complications leading to mortality. Post-operative echocardiography studies showed no evidence of stenosis, dilatation, calcification or thrombosis. Importantly, during the 10-year follow-up period no failures of the valved conduit were reported, suggesting that the tissue of the conduit does not structurally change (histology of one explant showed normal cusp and conduit).
The No-React® BioConduit composite stentless aortic valved conduit provides excellent long-term clinical results for aortic root replacement with few prosthesis-related complications in the first post-operative decade.
回顾性分析在单一中心采用Bentall手术植入全生物复合无支架带瓣主动脉管道（No-React®生物管道）超过十年的临床结果。
在1999年10月27日至2008年1月19日期间，67例患者植入了No-React®生物复合移植物。这些患者的数据从医院数据库、患者病历和问卷调查中收集。一组患者在术后平均4.3±0.45年接受二维超声心动图检查，以评估瓣膜功能、钙化情况和管道直径。
67例患者的植入代表了371.3患者年的随访。男性占手术人群的60%，平均年龄为67.9±1.3岁（范围34.1 - 83.8岁），其中21例年龄低于65岁。平均随访7.1±0.3年（范围2.2 - 10.5年）后，超过50%的存活者心功能分级为纽约心脏协会（NYHA）I/II级，超过60%的存活者无心绞痛（加拿大心血管学会[CCS] 0级）。主动脉瓣和主动脉根部置换后的总体10年生存率为51%。在此期间，88%的患者无导致死亡的带瓣管道相关并发症。术后超声心动图研究未显示狭窄、扩张、钙化或血栓形成的证据。重要的是，在10年随访期内未报告带瓣管道失败情况，提示管道组织在结构上未发生变化（一个取出物的组织学显示瓣叶和管道正常）。
No-React®生物复合无支架带瓣主动脉管道为主动脉根部置换提供了优异的长期临床结果，在术后第一个十年中假体相关并发症较少。
