Department of Cardiac Surgery, Montreal Heart Institute and Université de Montréal, Montreal, Quebec, Canada.
Department of Cardiac Surgery, Montreal Heart Institute and Université de Montréal, Montreal, Quebec, Canada.
Ann Thorac Surg. 2014 Mar;97(3):816-23. doi: 10.1016/j.athoracsur.2013.09.098. Epub 2013 Nov 23.
The CarboMedics mechanical prosthesis (CarboMedics Inc, Austin, TX) has been used for mitral and aortic valve replacement for more than 20 years in our institution. This study describes the long-term survival of patients with this prosthesis as well as the valve-related events.
Between June 1988 and May 2010, 3,297 patients underwent either single aortic valve replacement (AVR) (2,242 patients) or mitral valve replacement (MVR) (1,055 patients) with the CarboMedics mechanical valve prosthesis. They were followed annually for valve-related complications at the Montreal Heart Institute valve clinic.
Operative mortality was 4% with AVR and 7% with MVR. Total follow-up was 23,671 patient-years (range, 1 month to 21 years; average, 7.5 ± 5.3 years). At 20 years, patient freedom from late mortality was 43.2% in the AVR group and 40.9% in the MVR group. Freedom from valve-related mortality was 78.3% for AVR and 74.6% for MVR. Freedom from thromboembolic event was 91.6% for AVR and 88.5% for MVR. Freedom from reoperation was 89.2% for AVR and 80.3% for MVR. Freedom from bleeding event was 89.5% for AVR and 88% for MVR. Freedom from endocarditis was 97.3% for both AVR and MVR. Freedom from valve thrombosis was 98.9% for AVR and 91.4% for MVR. There was no structural valve failure in our cohort.
The CarboMedics valve is an effective and durable mechanical valve prosthesis with a low event rate and no structural failure at 20 years.
CarboMedics 机械瓣膜（CarboMedics Inc，奥斯汀，德克萨斯州）在我们机构已用于二尖瓣和主动脉瓣置换超过 20 年。本研究描述了使用该瓣膜的患者的长期生存率以及与瓣膜相关的事件。
1988 年 6 月至 2010 年 5 月期间，3297 例患者接受了 CarboMedics 机械瓣膜进行主动脉瓣置换术（AVR，2242 例）或二尖瓣置换术（MVR，1055 例）。他们在蒙特利尔心脏研究所瓣膜诊所每年接受一次与瓣膜相关并发症的随访。
AVR 的手术死亡率为 4%，MVR 的手术死亡率为 7%。总随访时间为 23671 患者年（范围 1 个月至 21 年；平均 7.5±5.3 年）。20 年时，AVR 组的晚期死亡率无事件生存率为 43.2%，MVR 组为 40.9%。AVR 的瓣膜相关死亡率无事件生存率为 78.3%，MVR 为 74.6%。AVR 的血栓栓塞事件无事件生存率为 91.6%，MVR 为 88.5%。AVR 的再次手术无事件生存率为 89.2%，MVR 为 80.3%。AVR 的出血事件无事件生存率为 89.5%，MVR 为 88%。AVR 和 MVR 的感染性心内膜炎无事件生存率均为 97.3%。AVR 的瓣膜血栓无事件生存率为 98.9%，MVR 为 91.4%。在我们的队列中没有结构性瓣膜衰竭。
CarboMedics 瓣膜是一种有效且耐用的机械瓣膜，20 年时的事件发生率低，无结构性瓣膜衰竭。
