Ito Yukinobu, Ohuchi Shingo, Okubo Tadashi, Harima Takanori, Sato Makoto, Igarashi Tomonori
Department of Cardiovascular Surgery, Nakadori General Hospital, Akita, Japan.
Kyobu Geka. 2013 Aug;66(9):833-6.
Aortic valve replacement using CEP Magna 21 mm bioprosthetic valve was performed because of aortic valve stenosis in a 75-year-old man with maintenance dialysis. In the 39th postoperative month, the bioprosthetic valve malfunction due to calcification was noted, and it was replaced. Judging from the previously reported cases, malfunction of an artificial valve in the 39th month is thought to be relatively early. Early-stage calcification of a bioprosthetic valve is considered to be caused by secondary hyperparathyroidism due to artificial dialysis. Therefore, careful consideration is necessary in selecting an artificial valve in a dialysis patient. To prevent early-stage calcification of a bioprosthetic valve in a dialysis patient, strict control of parathyroid hormones, blood phosphorus and calcium levels is necessary. In addition, due to the attendant risk of calcification of bioprosthetic valves, mechanical valves are recommended to dialysis patients, who are expected to survive for more than 3 years and who are not expected to develop hemorrhagic complications.
一名75岁维持性透析男性因主动脉瓣狭窄接受了使用CEP Magna 21毫米生物瓣膜的主动脉瓣置换术。术后第39个月，发现生物瓣膜因钙化出现功能障碍，并进行了更换。从既往报道的病例来看，人工瓣膜在第39个月出现功能障碍被认为相对较早。生物瓣膜的早期钙化被认为是由于人工透析导致的继发性甲状旁腺功能亢进所致。因此，在为透析患者选择人工瓣膜时需要仔细考虑。为防止透析患者生物瓣膜早期钙化，严格控制甲状旁腺激素、血磷和血钙水平是必要的。此外，由于生物瓣膜存在钙化风险，对于预期存活超过3年且预计不会发生出血并发症的透析患者，建议使用机械瓣膜。
