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[猪瓣膜生物假体。6年后的结果]

[Porcine valvular bioprosthesis. Results 6 years later].

作者信息

Vassal T, Leroy G, Desnos M, Fernandez F, Gay J

出版信息

Arch Mal Coeur Vaiss. 1987 Feb;80(2):133-41.

PMID:3107499
Abstract

Between January, 1977 and December, 1980, 128 porcine bioprostheses were implanted in 109 European patients hospitalized at the Boucicaut hospital, Paris: 47 were aortic valve replacements (AVR), 43 mitral valve replacements (MVR) and 19 dual valve replacements (DVR). The operative mortality rate was 11% (12 patients): MVR 21%, AVR 6.4%, DVR 0%. 3 patients were lost sight of. The mean follow-up period was 59.3 months (3-96 months). The overall survival rate at 6 years, including early deaths, was 74.4 +/- 8%: MVR 66.1 +/- 15%, AVR 84.9 +/- 10%, DVR 68.6 +/- 20%. Eighteen late deaths were reported (3.7% patient-years [PY]), 3 of which were due to the valve (0.6% PY). The probability at 6 years of escaping death due to the valve was 96.3 +/- 4%: MVR 96.9 +/- 4%, AVR 100%, DVR 87 +/- 17%. Complications associated with the valve were observed in 17 patients (3.5% PY); they were: degeneration in 2 (0.8% PY), thromboembolic accident in 2 (0.4% PY), haemorrhagic accident in 4 (0.8% PY), endocarditis in 5 (1% PY) and simple disinsertion in 2 (0.4% PY). The probability at 6 years of escaping a complication due to the valve was 80.7 +/- 10%: MVR 90.4 +/- 13%, AVR 81.8 +/- 13%, DVR 55.3 +/- 35%. The probability at 6 years of escaping death and re-operation due to the valve was 88.5 +/- 8%: MVR 96.0 +/- 6%, AVR 87.9 +/- 11%, DVR 60.2 +/- 37%. This study and those already published show that compared with mechanical prostheses, bioprostheses clearly reduce the incidence of thromboembolic and haemorrhagic accidents.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

1977年1月至1980年12月期间,128个猪生物瓣膜被植入巴黎布西科医院住院治疗的109名欧洲患者体内:47个用于主动脉瓣置换(AVR),43个用于二尖瓣置换(MVR),19个用于双瓣膜置换(DVR)。手术死亡率为11%(12例患者):MVR为21%,AVR为6.4%,DVR为0%。3例患者失访。平均随访期为59.3个月(3 - 96个月)。6年时的总生存率,包括早期死亡病例,为74.4±8%:MVR为66.1±15%,AVR为84.9±10%,DVR为68.6±20%。报告了18例晚期死亡(3.7%患者年[PY]),其中3例归因于瓣膜(0.6% PY)。6年时免于因瓣膜导致死亡的概率为96.3±4%:MVR为96.9±4%,AVR为100%,DVR为87±17%。17例患者观察到与瓣膜相关的并发症(3.5% PY);具体如下:2例发生退变(0.8% PY),2例发生血栓栓塞事件(0.4% PY),4例发生出血事件(0.8% PY),5例发生心内膜炎(1% PY),2例发生单纯瓣周脱离(0.4% PY)。6年时免于因瓣膜导致并发症的概率为80.7±10%:MVR为90.4±13%,AVR为81.8±13%,DVR为55.3±35%。6年时免于因瓣膜导致死亡和再次手术的概率为88.5±8%:MVR为96.0±6%,AVR为87.9±11%,DVR为60.2±37%。本研究以及已发表的研究表明,与机械瓣膜相比,生物瓣膜明显降低了血栓栓塞和出血事件的发生率。(摘要截选至250字)

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