65 岁及以下患者行 Mosaic 生物瓣置换术后的远期结果。
Late results after mitral valve replacement with Mosaic bioprosthesis in patients aged 65 years or younger.
机构信息
Cardiovascular and Thoracic Surgery Department, Clinique Pasteur, Toulouse, France.
Catholic University of the Sacred Heart, Rome, Italy.
出版信息
Interact Cardiovasc Thorac Surg. 2021 Jul 26;33(2):181-187. doi: 10.1093/icvts/ivab066.
OBJECTIVES
Although in younger patients indications for biological prosthesis implantation in mitral valve replacement remain controversial, recently bioprostheses use increased considerably. We present late results obtained with the Medtronic Mosaic bioprosthesis in patients aged 65 years or younger.
METHODS
Between 2007 and 2017, 67 mitral Mosaic bioprostheses were implanted in patients aged 65 years or younger (58.5 ± 6.4 years). Follow-up extended up to 13 years. Survival, freedom from structural valve degeneration, endocarditis, thromboembolic events and reoperation were considered as main clinical end points evaluated at 1, 5 and 10 years.
RESULTS
The mean follow-up was 4.7 ± 2.8 years. Overall mortality rate was 12%. At 1, 5 and 10 years, survival was 94 ± 3%, 89 ± 4% and 77 ± 9%, respectively. Freedom from structural valve degeneration was 100%, 94 ± 4% and 71 ± 21%. Freedom from endocarditis was 95 ± 3%, 90 ± 6% and 84 ± 8%. Freedom from thromboembolic events was 94 ± 3%, 90 ± 5% and 90 ± 5%. Freedom from reoperation was 94 ± 3%, 87 ± 5% and 65 ± 19%.
CONCLUSIONS
Mosaic bioprosthesis appears a valid mitral valve substitute even when employed in ≤65-year-old patients.
目的
尽管在年轻患者中，二尖瓣置换术生物假体植入的适应证仍存在争议，但最近生物假体的使用显著增加。我们介绍了在 65 岁或以下的患者中使用美敦力马赛克生物假体获得的晚期结果。
方法
2007 年至 2017 年，67 例二尖瓣马赛克生物假体在 65 岁或以下（58.5±6.4 岁）的患者中植入。随访时间最长为 13 年。生存、免于结构性瓣膜退行性变、心内膜炎、血栓栓塞事件和再次手术被视为主要临床终点，在 1、5 和 10 年进行评估。
结果
平均随访时间为 4.7±2.8 年。总死亡率为 12%。在 1、5 和 10 年时，生存率分别为 94±3%、89±4%和 77±9%。免于结构性瓣膜退行性变的比例为 100%、94±4%和 71±21%。免于心内膜炎的比例为 95±3%、90±6%和 84±8%。免于血栓栓塞事件的比例为 94±3%、90±5%和 90±5%。免于再次手术的比例为 94±3%、87±5%和 65±19%。
结论
即使在≤65 岁的患者中，马赛克生物假体似乎也是一种有效的二尖瓣替代物。
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