Robert Wood Johnson Clinical Scholars Program, Department of Internal Medicine, Yale School of Medicine, New Haven, CT 06520, USA.
Department of Cardiothoracic Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA.
Cardiol Res Pract. 2014;2014:151282. doi: 10.1155/2014/151282. Epub 2014 Dec 2.
Background and Aim. While aortic valve replacement for aortic stenosis can be performed safely in elderly patients, there is a need for hemodynamic and quality of life evaluation to determine the value of aortic valve replacement in older patients who may have age-related activity limitation. Materials and Methods. We conducted a prospective evaluation of patients who underwent aortic valve replacement for aortic stenosis with the Hancock II porcine bioprosthesis. All patients underwent transthoracic echocardiography (TTE) and completed the RAND 36-Item Health Survey (SF-36) preoperatively and six months postoperatively. Results. From 2004 to 2007, 33 patients were enrolled with an average age of 75.3 ± 5.3 years (24 men and 9 women). Preoperatively, 27/33 (82%) were New York Heart Association (NYHA) Functional Classification 3, and postoperatively 27/33 (82%) were NYHA Functional Classification 1. Patients had a mean predicted maximum V O2 (mL/kg/min) of 19.5 ± 4.3 and an actual max V O2 of 15.5 ± 3.9, which was 80% of the predicted V O2 . Patients were found to have significant improvements (P ≤ 0.01) in six of the nine SF-36 health parameters. Conclusions. In our sample of elderly patients with aortic stenosis, replacing the aortic valve with a Hancock II bioprosthesis resulted in improved hemodynamics and quality of life.
背景与目的。虽然主动脉瓣置换术可安全应用于老年主动脉瓣狭窄患者，但需要进行血流动力学和生活质量评估，以确定主动脉瓣置换术在可能因年龄相关活动受限的老年患者中的价值。材料与方法。我们对 33 例行 Hancock II 猪生物瓣主动脉瓣置换术的主动脉瓣狭窄患者进行了前瞻性评估。所有患者均行经胸超声心动图（TTE）检查，并于术前和术后 6 个月完成 RAND 36 项健康调查（SF-36）。结果。2004 年至 2007 年，共纳入 33 例患者，平均年龄为 75.3±5.3 岁（24 例男性，9 例女性）。术前，33 例患者中有 27 例（82%）为纽约心脏协会（NYHA）心功能分级 3 级，术后有 27 例（82%）为 NYHA 心功能分级 1 级。患者平均预测最大 VO2（ml/kg/min）为 19.5±4.3，实际最大 VO2 为 15.5±3.9，为预测 VO2 的 80%。患者在 SF-36 健康参数的 9 项中有 6 项得到了显著改善（P≤0.01）。结论。在我们的老年主动脉瓣狭窄患者样本中，用 Hancock II 生物瓣置换主动脉瓣可改善血流动力学和生活质量。
