Vallejo J L, Gonzalez-Santos J M, Albertos J, Riesgo M J, Bastida M E, Rico M J, Gonzalez-Diego F, Arcas R
Department of Cardiac Surgery, General Hospital Gregorio Marañon, School of Medicine, Universidad Complutense, Madrid, Spain.
Ann Thorac Surg. 1990 Sep;50(3):429-36. doi: 10.1016/0003-4975(90)90489-s.
During the period January 1981 to September 1986, 444 Medtronic-Hall heart valve prostheses were implanted in 351 patients (mean age, 45 +/- 10 years) mainly for rheumatic valve disease (63.2%). Most of the patients were in New York Heart Association functional class III. Concomitant surgical procedures, mainly conservative tricuspid or mitral procedures or coronary artery bypass grafting, were performed in 101 patients (28.7%). Single-valve replacement was performed in 262 patients (74.6%) (aortic in 117 patients, mitral in 143, and tricuspid in 2), double-valve replacement in 85 (24.2%) (mitral and aortic in 83 and mitral and tricuspid in 2), and triple-valve replacement in 4 (1.1%). Hospital mortality was 6.2%. Follow-up was 97.7% complete. The overall actuarial 8-year survival rate was 77.2%. The linearized incidence of valve-related complications was as follows: thromboembolism, 1.5%/patient-year; reoperation, 1.5%/patient-year; endocarditis, 1.25%/patient-year; hemolysis, 0.52%/patient-year; anticoagulant-related hemorrhage, 0.39%/patient-year; and noninfection-related paraprosthetic leak, 0.33%/patient-year. There were no instances of structural failure. We conclude that after 8 years of follow-up, the Medtronic-Hall valve prosthesis has an excellent clinical performance and a low range of valve-related complications.
在1981年1月至1986年9月期间，351例患者（平均年龄45±10岁）植入了444枚美敦力-霍尔心脏瓣膜假体，主要用于治疗风湿性瓣膜病（63.2%）。大多数患者处于纽约心脏协会心功能Ⅲ级。101例患者（28.7%）接受了同期外科手术，主要是保守性三尖瓣或二尖瓣手术或冠状动脉搭桥术。262例患者（74.6%）进行了单瓣膜置换（117例主动脉瓣置换、143例二尖瓣置换、2例三尖瓣置换），85例患者（24.2%）进行了双瓣膜置换（83例二尖瓣和主动脉瓣置换、2例二尖瓣和三尖瓣置换），4例患者（1.1%）进行了三瓣膜置换。医院死亡率为6.2%。随访完成率为97.7%。总体8年精算生存率为77.2%。瓣膜相关并发症的线性化发生率如下：血栓栓塞，1.5%/患者年；再次手术，1.5%/患者年；心内膜炎，1.25%/患者年；溶血，0.52%/患者年；抗凝相关出血，0.39%/患者年；非感染性人工瓣膜旁漏，0.33%/患者年。未发生结构故障。我们得出结论，经过8年的随访，美敦力-霍尔瓣膜假体具有出色的临床性能和较低的瓣膜相关并发症发生率。
