Akhtar Raja Parvez, Abid Abdul Rehman, Nuqshband Mumraiz Salik, Khan Jawad Sajid
Department of Cardiac Surgery, Punjab Institute of Cardiology, Lahore, Pakistan.
J Coll Physicians Surg Pak. 2012 Oct;22(10):617-21. doi: 10.2012/JCPSP.617621.
To determine the effect of aortic prosthesis size on clinical outcome of patients undergoing double cardiac valve replacement (DVR).
A quasi-experimental study.
Cardiac Surgery Department, Punjab Institute of Cardiology, Lahore, Pakistan, from February 1996 to December 2008.
One hundred and forty patients undergoing double cardiac valve replacement were divided into 2 groups. Group I, 75 (53.6%) receiving aortic prosthesis size of ² 21 mm. Group II, 65 (46.4%) having aortic prosthesis of > 21 mm size. All patients were prospectively followed-up for 12 years in order to study mortality and valve related complications.
There were 94 males (67.1%) and 46 females (32.9%) with a mean age of 25.5 ± 10 years. In Group I, 21 patients (28%) had aortic valve replacement (AVR) with 19 mm valve size and 54 patients (72%) had 21 mm size valves implanted. In Group II, 39 patients (60%) had AVR with 23 mm size valves implanted followed by 16 (24.6%) who received 25 mm size valves. Posterior mitral leaflet was preserved in 15 patients (20%) in Group I and 14 (21.5%) in Group II. Mortality was seen in 13 patients (9.3%); of these 5 (3.6%) were in Group I and 8 (5.7%) were in Group II. Nine patients (6.4%) had incomplete follow-up (In Group I, 2 patients died in ICU, 2 died within 30 days of admission and one was a late death. In Group II, 1 patient died in ICU, 1 within 30 days of admission and 6 within 1 year of operation).
Double valve replacement with implantation of small aortic prosthesis has similar overall mortality as compared to patients having larger sized aortic valves.
确定主动脉瓣人工瓣膜大小对接受双心脏瓣膜置换术（DVR）患者临床结局的影响。
一项准实验研究。
1996年2月至2008年12月，巴基斯坦拉合尔旁遮普心脏病学研究所心脏外科。
140例接受双心脏瓣膜置换术的患者被分为两组。第一组75例（53.6%），接受的主动脉瓣人工瓣膜尺寸≥21mm。第二组65例（46.4%），主动脉瓣人工瓣膜尺寸>21mm。所有患者均进行了为期12年的前瞻性随访，以研究死亡率和瓣膜相关并发症。
共有94例男性（67.1%）和46例女性（32.9%），平均年龄为25.5±10岁。在第一组中，21例患者（28%）接受了19mm瓣膜尺寸的主动脉瓣置换术（AVR），54例患者（72%）植入了21mm尺寸的瓣膜。在第二组中，39例患者（60%）接受了23mm尺寸瓣膜的AVR，随后有16例（24.6%）接受了25mm尺寸的瓣膜。第一组15例患者（20%）保留了二尖瓣后叶，第二组14例患者（21.5%）保留了二尖瓣后叶。13例患者（9.3%）出现死亡；其中第一组5例（3.6%），第二组8例（5.7%）。9例患者（6.4%）随访不完整（第一组中，2例患者在重症监护病房死亡，2例在入院后30天内死亡，1例为晚期死亡。第二组中，1例患者在重症监护病房死亡，1例在入院后30天内死亡，6例在术后1年内死亡）。
与植入较大尺寸主动脉瓣的患者相比，植入较小主动脉瓣人工瓣膜的双瓣膜置换术总体死亡率相似。
