Vassal T, Leroy G, Desnos M, Fernandez F, Gay J
Arch Mal Coeur Vaiss. 1987 Feb;80(2):133-41.
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)
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）
