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40岁以下风湿性心脏病患者使用卡朋蒂埃-爱德华兹心包生物瓣膜进行二尖瓣置换术:17年随访结果

Mitral Valve Replacement Using Carpentier-Edwards Pericardial Bioprosthesis in Patients With Rheumatic Heart Disease Aged Below 40 Years: 17-Year Results.

作者信息

Chowdhury Ujjwal Kumar, Rizvi Adil, Narang Rajeev, Seth Sandeep, Kalaivani Mani, Hasija Suruchi, Kumari Lakshmi

机构信息

Department of Cardiothoracic and Vascular Surgery, All India Institute of Medical Sciences, New Delhi, India.

Department of Cardiothoracic and Vascular Surgery, All India Institute of Medical Sciences, New Delhi, India.

出版信息

Heart Lung Circ. 2018 Jul;27(7):864-871. doi: 10.1016/j.hlc.2017.05.147. Epub 2017 Aug 1.

Abstract

BACKGROUND

This study was designed to evaluate patients aged less than 40 years implanted with tissue heart valves with respect to survival, thromboembolism, structural degeneration and quality of life.

METHODS

Between January, 2000 and December, 2016, 132 patients (51 males) with rheumatic heart disease underwent mitral valve replacement using Carpentier-Edwards, perimount, pericardial bioprostheses. The patients' ages ranged between 12 and 39 years (mean±SD 30.12±5.51 years).

RESULTS

The hospital and late mortality were 1.5% and 1.5% respectively. The total cumulative follow-up period was 1330.98 patient-years with a mean of 124.78±50.3 months (range, 1-204 months). The actuarial survival and actuarial event-free survival at 204 months was 96.9% (±0.01%) and 93.4%(±0.03%) respectively. There was one episode of thromboembolism (0.32 events per 100 patient years). Six (4.7%) patients underwent redo mitral valve replacement for severe bioprosthetic degeneration with stiffening and calcification using a Medtronic mechanical prosthesis (Medtronic Open Pivot, MN, USA).

CONCLUSIONS

We conclude that Carpentier-Edwards perimount pericardial prosthesis provides satisfactory clinical performance in a young population with a low risk of degeneration and other valve-related events.

摘要

背景

本研究旨在评估年龄小于40岁的组织心脏瓣膜植入患者的生存情况、血栓栓塞、结构退变及生活质量。

方法

2000年1月至2016年12月期间,132例(51例男性)风湿性心脏病患者接受了使用Carpentier-Edwards、Perimount心包生物瓣膜的二尖瓣置换术。患者年龄在12至39岁之间(平均±标准差30.12±5.51岁)。

结果

住院死亡率和晚期死亡率分别为1.5%和1.5%。总累积随访期为1330.98患者年,平均为124.78±50.3个月(范围1 - 204个月)。204个月时的精算生存率和无事件精算生存率分别为96.9%(±0.01%)和93.4%(±0.03%)。发生1次血栓栓塞事件(每100患者年0.32次事件)。6例(4.7%)患者因严重生物瓣膜退变伴僵硬和钙化,使用美敦力机械瓣膜(美敦力开放枢轴,美国明尼苏达州)进行了再次二尖瓣置换术。

结论

我们得出结论,Carpentier-Edwards Perimount心包瓣膜在年轻人群中具有令人满意的临床性能,退变和其他瓣膜相关事件的风险较低。

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