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牛心包有机瓣生物瓣的安全性、有效性和血液动力学性能。

Safety, Effectiveness, and Hemodynamic Performance of the Bovine Pericardium Organic Valvular Bioprosthesis.

机构信息

Department of Cardiovascular Surgery, Hospital São Francisco, Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil.

Department of Cardiovascular Surgery, Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (INCOR-HCFMUSP), São Paulo, São Paulo, Brazil.

出版信息

Braz J Cardiovasc Surg. 2023 Oct 5;38(6):e20230015. doi: 10.21470/1678-9741-2023-0015.

Abstract

OBJECTIVE

To assess actual data on the safety, effectiveness, and hemodynamic performance of Bovine Pericardium Organic Valvular Bioprosthesis (BVP).

METHODS

The BIOPRO Trial is an observational, retrospective, non-comparative, non-randomized, and multicenter study. We collected data from 903 patients with symptomatic, moderate, or severe valve disease who underwent BVP implants in the timeframe from 2013 to 2020 at three Brazilian institutions. Death, valve-related adverse events (AEs), functional recovery, and hemodynamic performance were evaluated at the hospital, at discharge, and six months and one year later. Primary analysis compared late (> 30 days after implant) linearized rates of valve-related AEs, such as thromboembolism, valve thrombosis, major hemorrhage, major paravalvular leak, and endocarditis, following objective performance criteria (OPC). Analysis was performed to include at least 400 valve-years for each valve position (aortic and mitral) for complete comparisons to OPC. Kaplan-Meier survival and major adverse cardiovascular and cerebrovascular event analyses were also performed.

RESULTS

This retrospective study analyzed follow-up data collected from 903 patients (834.2 late patient-years) who have undergone surgery for 455 isolated aortic valve replacement (50.4%), 382 isolated mitral valve replacement (42.3%), and 66 combined valve replacement or other intervention (7.3%). The linearized rates of valve-related AEs were < 2 × OPC. One-year survival rates were 95.1% and 92.7% for aortic and mitral valve replacement, respectively. This study demonstrated an improvement in the New York Heart Association classification from baseline and hemodynamic performance within an expected range.

CONCLUSION

According to this analysis, BVP meets world standards for safety and clinical efficacy.

摘要

目的

评估牛心包有机瓣(Bovine Pericardium Organic Valvular Bioprosthesis,BVP)的安全性、有效性和血流动力学性能的实际数据。

方法

BIOPRO 试验是一项观察性、回顾性、非对照、非随机和多中心研究。我们从 2013 年至 2020 年在巴西的三个机构接受 BVP 植入治疗的 903 例有症状、中度或重度瓣膜疾病患者中收集数据。在医院、出院时以及 6 个月和 1 年后评估死亡、与瓣膜相关的不良事件(Adverse Events,AEs)、功能恢复和血流动力学性能。主要分析比较了根据客观性能标准(Objective Performance Criteria,OPC)评估的晚期(植入后>30 天)与瓣膜相关 AEs(如血栓栓塞、瓣膜血栓形成、大出血、严重瓣周漏和心内膜炎)的线性化发生率。分析包括每个瓣膜位置(主动脉瓣和二尖瓣)至少 400 个瓣膜年,以便与 OPC 进行完整比较。还进行了 Kaplan-Meier 生存和主要不良心血管和脑血管事件分析。

结果

这项回顾性研究分析了 903 例患者(834.2 个晚期患者年)的随访数据,这些患者接受了 455 例单纯主动脉瓣置换术(50.4%)、382 例单纯二尖瓣置换术(42.3%)和 66 例联合瓣膜置换术或其他干预术(7.3%)。与瓣膜相关的 AEs 的线性化发生率<2×OPC。主动脉瓣和二尖瓣置换术的 1 年生存率分别为 95.1%和 92.7%。本研究显示,纽约心脏协会(New York Heart Association)分类从基线改善,血流动力学性能在预期范围内。

结论

根据这项分析,BVP 符合安全性和临床疗效的世界标准。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f19d/10549993/7edf3bd8e588/bjcvs-38-06-e20230015-g01.jpg

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