Nitter-Hauge S, Abdelnoor M
Medical Department B, Rikshospitalet, University of Oslo, Norway.
Circulation. 1989 Sep;80(3 Pt 1):I43-8.
The Medtronic Hall valvular prosthesis was introduced in 1977 and was used for the first time in Oslo in June of that year. We report here our 10-year experience with this prosthesis, based on studies of all 1,104 consecutive patients who were operated on from June 1977 to August 1987. There were 816 aortic (AVR), 187 mitral (MVR), and 101 combined mitral and aortic (double, DVR) valve replacements. Cumulative follow-up was 5,061 patient-years, with a mean follow-up of 4.6 years. Early mortality was 3.8% after AVR, 7.5% after MVR, and 10.0% after DVR. The probability of surviving 10 years after AVR was 72%; after MVR, 56%; and after DVR, 60%. Early and late survival reflected the patient's preoperative status and nonvalvular cardiac disease. Thromboembolism occurred at linearized rates of 1.3%, 1.3%, and 1.8%/yr after AVR, MVR, and DVR, respectively. There were five cases of valvular thrombosis, none fatal, resulting in a linearized rate of 0.1%, 0.1%, and 0.2%/yr after AVR, MVR, and DVR, respectively. There were no instances of structural failure. Morbidity from anticoagulant-related hemorrhage was 0.7%/yr, with seven fatal events, all of cerebral origin. The long-term experience with the Medtronic Hall valve indicates that, in addition to its previously demonstrated excellent hemodynamic performance, there are low risks of thromboembolism and thrombosis and no instances of primary structural failure.
美敦力Hall瓣膜假体于1977年推出，并于同年6月在奥斯陆首次使用。在此，我们报告基于对1977年6月至1987年8月连续接受手术的1104例患者的研究，使用该瓣膜假体的10年经验。其中有816例主动脉瓣置换术（AVR）、187例二尖瓣置换术（MVR）以及101例二尖瓣和主动脉瓣联合置换术（双瓣置换术，DVR）。累积随访时间为5061患者年，平均随访时间为4.6年。AVR术后早期死亡率为3.8%，MVR术后为7.5%，DVR术后为10.0%。AVR术后10年生存概率为72%；MVR术后为56%；DVR术后为60%。早期和晚期生存率反映了患者的术前状况和非瓣膜性心脏病。AVR、MVR和DVR术后血栓栓塞的线性发生率分别为每年1.3%、1.3%和1.8%。有5例瓣膜血栓形成，均非致命，AVR、MVR和DVR术后的线性发生率分别为每年0.1%、0.1%和0.2%。没有发生结构故障的情况。抗凝相关出血的发病率为每年0.7%，有7例致命事件，均源于脑部。美敦力Hall瓣膜的长期经验表明，除了其先前已证明的出色血流动力学性能外，血栓栓塞和血栓形成的风险较低，且没有原发性结构故障的情况。
