Montalescot G, Drobinski G, Thomas D, Grosgogeat Y
Service de cardiologie, Hôpital Pitié-Salpêtrière, Paris.
Arch Mal Coeur Vaiss. 1988 Apr;81(4):485-92.
Changes in left ventricular function were evaluated in twelve patients with aortic valve stenosis and in eleven patients with aortic valve regurgitation in order to find out whether the results obtained soon after aortic valve replacement persisted over a long period. All patients had been provided with a St-Jude Medical valve. Evaluation included electrocardiography, radiography of the chest, phonocarotidography and echocardiography and was performed preoperatively, then three months and five years on average in each patient after surgery. In patients with aortic valve stenosis, the left ventricular mass clearly regressed during the first three months (p less than 0.01) and continued to regress, albeit not significantly, over five years. In patients with aortic valve regurgitation, the left ventricular volume and mass regressed significantly during the first three months and remained normal for five years. No significant variation in systolic performance was observed in both groups. In spite of good overall results, 26 p. 100 of the patients had an unfavourable long-term outcome as they developed major left ventricular dilatation. Nos prosthesis dysfunction was observed, and the St Jude Medical valve caused little obstruction. Thus, with this little obstructive prosthesis the postoperative improvement obtained persisted for five years in most cases of aortic valve stenosis or regurgitation.
为了弄清楚主动脉瓣置换术后短期内获得的结果是否能长期持续,对12例主动脉瓣狭窄患者和11例主动脉瓣反流患者的左心室功能变化进行了评估。所有患者均植入了圣犹达医疗公司生产的瓣膜。评估包括心电图、胸部X光、心音图和超声心动图,在术前进行,然后在术后平均三个月和五年对每位患者进行评估。在主动脉瓣狭窄患者中,左心室质量在术后头三个月明显减轻(p<0.01),并在五年内持续减轻,尽管不显著。在主动脉瓣反流患者中,左心室容积和质量在头三个月显著减轻,并在五年内保持正常。两组患者的收缩功能均未观察到显著变化。尽管总体结果良好,但100例患者中有26例出现了严重的左心室扩张,长期预后不佳。未观察到人工瓣膜功能障碍,圣犹达医疗瓣膜造成的梗阻很小。因此,在大多数主动脉瓣狭窄或反流病例中,使用这种梗阻性小的人工瓣膜,术后改善情况可持续五年。