Zeien L B, Klatt E C
Department of Pathology, Los Angeles County, University of Southern California Medical Center 90033.
Arch Pathol Lab Med. 1990 Sep;114(9):933-7.
We describe the pathologic findings at autopsy in 96 persons who had undergone prosthetic heart valve implantation. The most common indication for implantation was rheumatic heart disease (58%), followed by infective endocarditis (22%). Cardiac failure led to death in two thirds of the cases, most often from infective endocarditis (18%) and congestive heart failure (13%). Failure of the prosthetic valve caused death in eight cases. There were 13 deaths intraoperatively or in the immediate postoperative period. Patients with mechanical prostheses survived longer than did those with bioprostheses. The most common prosthesis-related complication was thrombosis, found in 23% of mechanical valves and 11% of bioprostheses. Thrombosis led to death in only 4 cases. Thromboembolic phenomena led to nine deaths and were not related to anticoagulant therapy. These findings provide an approach to investigation, description, and diagnosis of prosthetic heart valves at autopsy.
我们描述了96例接受人工心脏瓣膜植入术患者的尸检病理结果。植入人工心脏瓣膜最常见的指征是风湿性心脏病（58%），其次是感染性心内膜炎（22%）。三分之二的病例死于心力衰竭，最常见的原因是感染性心内膜炎（18%）和充血性心力衰竭（13%）。人工瓣膜功能衰竭导致8例死亡。有13例在术中或术后即刻死亡。植入机械瓣膜的患者比植入生物瓣膜的患者存活时间更长。最常见的与人工瓣膜相关的并发症是血栓形成，在23%的机械瓣膜和11%的生物瓣膜中发现。血栓形成仅导致4例死亡。血栓栓塞现象导致9例死亡，且与抗凝治疗无关。这些发现为尸检时人工心脏瓣膜的调查、描述和诊断提供了一种方法。
