Mikaeloff P, Jegaden O, Rumolo A, Bonnefoy J Y
Service de chirurgie thoracique et cardio-vasculaire, hôpital cardiologique, Bron.
Arch Mal Coeur Vaiss. 1988 Jan;81(1):71-9.
Over this 15-year period, 322 combined aortic and mitral valve replacements were performed by the same surgeon. Bioprostheses were used in only 4 patients, 318 received a double mechanical prosthesis. The Bjork-Shiley valve was always used for the aortic orifice. For the mitral orifice, three types of valve were implanted: 160 Starr-Edwards 6120 valves, 59 Bjork-Shiley valves and 99 St-Jude Medical valves. The early post-operative mortality was 5.9 p. 100. It was due to cardiac causes in 73.7 p. 100 of the cases and was significantly influenced by the myocardial protection technique (p less than 0.05). A long-term review of the survivors was carried out in november-december, 1986: 15 patients were lost sight of; there were 63 late deaths 77.8 p. 100 of which were either of cardiac origin or due to the prosthesis. 225 patients have survived with a mean follow-up of 79.1 months. The actuarial survival rate (early post-operative mortality included) was 78.2 p. 100 at 5 years and 70.2 p. 100 at 10 years. The incidence of peripheral arterial embolism was 1.9 p. 100 per patient-year, while that of all thromboembolic complications (sudden deaths included) was 3.4 p. 100 per patient-year. The percentages per patient-year of the other complications observed were: haemorrhages 2.2 p. 100, infective endocarditis 0.40 p. 100, reoperation 0.47 p. 100. The proportions of patients free of any complication were 84.8 p. 100 at 5 years and 79.7 p. 100 after 10 years.(ABSTRACT TRUNCATED AT 250 WORDS)
在这15年期间，同一位外科医生进行了322例主动脉瓣和二尖瓣联合置换手术。仅4例患者使用了生物瓣膜，318例接受了双机械瓣膜置换。主动脉瓣口始终使用比约克-希利瓣膜。二尖瓣口植入了三种类型的瓣膜：160个斯塔尔-爱德华兹6120瓣膜、59个比约克-希利瓣膜和99个圣犹达医疗瓣膜。术后早期死亡率为5.9%。其中73.7%的病例死于心脏原因，且受心肌保护技术的显著影响（P<0.05）。1986年11月至12月对幸存者进行了长期随访：15例失访；有63例晚期死亡，其中77.8%死于心脏原因或与人工瓣膜有关。225例患者存活，平均随访79.1个月。（包括术后早期死亡率的）精算生存率在5年时为78.2%，10年时为70.2%。外周动脉栓塞的发生率为每患者年1.9%，而所有血栓栓塞并发症（包括猝死）的发生率为每患者年3.4%。观察到的其他并发症每患者年的发生率分别为：出血2.2%、感染性心内膜炎0.40%、再次手术0.47%。无任何并发症的患者比例在5年时为84.8%，10年后为79.7%。（摘要截取自250字）
