Kawazoe K, Kawaguchi O, Kosakai Y, Ohara K, Kito Y, Fujita T
Dept. of Surgery Natinal Cardiovascular Center, Suita, Japan.
Nihon Geka Gakkai Zasshi. 1989 Sep;90(9):1534-7.
The three series with the first-generation valve prostheses were reviewed for long-term clinical evaluation in isolated aortic and mitral valve replacement. Hancock porcine xenograft was implanted in 71 patients from 1977 to 1979, ionescu-Shiley pericardial xenograft (standard model) in 271 patients from 1979 to 1983, and Bjork-Shiley tilting disc valve in 194 from 1978 to 1986. In aortic position, no any significant difference among three valve types could be demonstrated in the actuarial survival and freedom from thromboembolism and valve infection, while the actuarial freedom from valve dysfunction in lonescu-Shiley valve was significantly lower than that in other two valves. Björk-Shiley valve in mitral position showed satisfactory clinical performance in terms of valve-related complications and survival in comparison with two types of bioprosthetic valves. In our conclusion at present time, Björk-Shiley valve is suitable for the first choice of both aortic and mitral valve prostheses. In case of valve replacement with a bioprosthesis, however, porcine aortic valve is a better choice for aortic, and bovine pericardial valve likely for mitral replacement.
对采用第一代瓣膜假体的三个系列进行回顾,以对单纯主动脉瓣和二尖瓣置换进行长期临床评估。1977年至1979年,71例患者植入了汉考克猪异种移植物瓣膜;1979年至1983年,271例患者植入了伊奥内斯库-希利心包异种移植物瓣膜(标准型号);1978年至1986年,194例患者植入了比约克-希利倾斜碟瓣。在主动脉瓣位,三种瓣膜类型在精算生存率、无血栓栓塞和瓣膜感染方面无显著差异,而伊奥内斯库-希利瓣膜无瓣膜功能障碍的精算自由度显著低于其他两种瓣膜。与两种生物瓣膜相比,二尖瓣位的比约克-希利瓣膜在瓣膜相关并发症和生存率方面表现出令人满意的临床效果。目前我们的结论是,比约克-希利瓣膜适合作为主动脉瓣和二尖瓣假体的首选。然而,在进行生物瓣膜置换时,猪主动脉瓣可能是主动脉瓣置换的更好选择,而牛心包瓣可能是二尖瓣置换的更好选择。