60 岁以下主动脉瓣置换术患者 20 年的随访经验。
Twenty-year experience following aortic valve replacement in patients younger than 60 years of age.
机构信息
Department of Cardiovascular Surgery, Iwate Medical University, 2-1-1 Idaidori, Yahaba-cho, Shiwa-gun, Iwate, Yahaba, 028-3695, Japan.
Department of Thoracic and Cardiovascular Surgery, Hirosaki University, Hirosaki, Japan.
出版信息
J Cardiothorac Surg. 2024 May 7;19(1):279. doi: 10.1186/s13019-024-02776-x.
OBJECTIVE
Reports on long-term outcomes of surgical aortic valve replacement (AVR) for patients aged < 60 years are scarce in Japan. Hence, we aimed to evaluate these outcomes in patients aged < 60 years.
METHODS
Between March 2000 and December 2020, 1477 patients underwent aortic valve replacement. In total, 170 patients aged < 60 years who underwent aortic valve replacement were recruited. Patients aged < 18 years were excluded. Patient data collected from the operative records and follow-up assessments were reviewed.
RESULTS
The mean age was 49 ± 9 years, and 64.1% of patients were male. One-hundred-and-fifty-two patients (89.4%) underwent aortic valve replacement with a mechanical valve and 18 (10.6%) with a bioprosthetic valve. The mean follow-up period was 8.1 ± 5.5 years. No operative mortality occurred, and in-hospital mortality occurred in one patient (0.6%). Ten late deaths occurred, with seven cardiac-related deaths. The overall survival rate was 95.4 ± 1.7%, 93.9 ± 2.3%, 90.6 ± 3.9%, and 73.2 ± 11.8% at 5, 10, 15, and 20 years, respectively. Freedom from major bleeding was 96.4 ± 1.6% at 5, 10, and 15 years, and 89.0 ± 7.3% at 20 years. Freedom from thromboembolic events was 98.7 ± 1.3%, 97.3 ± 1.9%, 90.5 ± 4.5%, and 79.0 ± 11.3% at 5, 10, 15, and 20 years, respectively. Freedom from valve-related reoperation was 99.4 ± 0.6% at 5 years, 97.8 ± 1.7% at 10 and 15 years, and 63.9 ± 14.5% at 20 years.
CONCLUSIONS
Patients aged < 60 years undergoing aortic valve replacement with a high mechanical valve implantation rate had favorable long-term outcomes.
目的
在日本，关于年龄<60 岁患者接受外科主动脉瓣置换术（AVR）的长期结果的报告很少。因此，我们旨在评估这些年龄<60 岁患者的结果。
方法
2000 年 3 月至 2020 年 12 月期间，共有 1477 名患者接受了主动脉瓣置换术。共招募了 170 名年龄<60 岁接受主动脉瓣置换术的患者。排除年龄<18 岁的患者。从手术记录和随访评估中收集患者数据。
结果
平均年龄为 49±9 岁，64.1%的患者为男性。152 名（89.4%）患者接受机械瓣主动脉瓣置换术，18 名（10.6%）患者接受生物瓣主动脉瓣置换术。平均随访时间为 8.1±5.5 年。无手术死亡，住院期间死亡 1 例（0.6%）。10 例晚期死亡，其中 7 例与心脏相关。总体生存率为 95.4±1.7%、93.9±2.3%、90.6±3.9%和 73.2±11.8%，分别为 5、10、15 和 20 年。5、10 和 15 年时，主要出血无复发率为 96.4±1.6%，20 年时为 89.0±7.3%。血栓栓塞事件无复发率为 98.7±1.3%、97.3±1.9%、90.5±4.5%和 79.0±11.3%，分别为 5、10、15 和 20 年。瓣膜相关再次手术无复发率为 99.4±0.6%，5 年时为 97.8±1.7%，10 年和 15 年时为 90.5±14.5%，20 年时为 63.9±14.5%。
结论
接受高机械瓣植入率主动脉瓣置换术的年龄<60 岁患者具有良好的长期结果。
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