Spencer F C, Baumann F G, Grossi E A, Culliford A T, Galloway A C
Ann Surg. 1986 Jun;203(6):691-700. doi: 10.1097/00000658-198606000-00015.
Sixteen hundred and forty-three porcine prosthetic values (1102 Carpentier-Edwards, 541 Hancock) were implanted in 1492 patients at New York University Medical Center between January 1976 and June 1983. The aortic valve alone was replaced in 786 patients (53%), mitral valve alone in 556 (37%), and multiple valves in 143 patients (9.6%). Concomitant coronary artery bypass was performed in 326 patients (22%). There were 116 deaths within 30 days of operation (7.8%). Follow-up (mean: 42 months) was completed in 94% of survivors and revealed that late survival from cardiac-related death was 87% at 5 years and 81% at 7 years, with no significant difference between the Carpentier-Edwards and Hancock patients. Late thromboembolic complications, however, were significantly more frequent in Hancock patients at all intervals from 1-7 years (p less than 0.05), whether in the aortic or mitral position. Patients with coronary artery disease who had concomitant coronary bypass showed a survival from late cardiac death that did not differ significantly from that of patients undergoing valve replacement alone. Before operation, 87% of patients were in New York Heart Association Class III or IV, but after operation 80% were in Class I or II. Late anticoagulant complications, endocarditis, and valve dysfunction were relatively rare. These results from a series of such size, duration, and representative numbers of two types of porcine bioprosthesis confirm excellent results with porcine prostheses in the first 4-5 years following operation.
1976年1月至1983年6月期间，纽约大学医学中心的1492例患者植入了1643个猪生物瓣膜（1102个Carpentier-Edwards瓣膜，541个Hancock瓣膜）。仅主动脉瓣置换的患者有786例（53%），仅二尖瓣置换的患者有556例（37%），多瓣膜置换的患者有143例（9.6%）。326例患者（22%）同时进行了冠状动脉搭桥术。术后30天内有116例死亡（7.8%）。94%的幸存者完成了随访（平均42个月），结果显示，与心脏相关死亡的晚期生存率在5年时为87%，7年时为81%，Carpentier-Edwards瓣膜患者和Hancock瓣膜患者之间无显著差异。然而，在1至7年的所有时间段内，Hancock瓣膜患者的晚期血栓栓塞并发症明显更频繁（p<0.05），无论是主动脉瓣还是二尖瓣位置。接受冠状动脉搭桥术的冠心病患者晚期心脏死亡的生存率与仅接受瓣膜置换术的患者无显著差异。术前，87%的患者为纽约心脏协会III或IV级，但术后80%的患者为I或II级。晚期抗凝并发症、心内膜炎和瓣膜功能障碍相对少见。这一系列如此规模、时长以及包含两种猪生物瓣膜代表性数量的结果证实了猪瓣膜在术后最初4至5年内的出色效果。
