Zussa C, Ottino G, di Summa M, Poletti G A, Zattera G F, Pansini S, Morea M
Ann Thorac Surg. 1985 Mar;39(3):243-50. doi: 10.1016/s0003-4975(10)62587-8.
Clinical results with porcine bioprostheses were reviewed for 990 patients who underwent heart valve replacement from January, 1974, to December, 1980. Eight hundred and seventy-four Hancock, 283 Carpentier-Edwards, and 10 Liotta bioprostheses were used. In 23 patients, 26 mechanical prostheses were implanted as well. Overall operative mortality was 60 out of 990 (6.06%): 30 out of 506 (5.9%) for mitral valve replacement (MVR), 13 out of 287 (4.5%) for aortic valve replacement (AVR), 1 out of 4 (25%) for tricuspid valve replacement, 0 out of 2 for pulmonary valve replacement, and 16 out of 191 (8.4%) for multiple valve replacement. Cumulative follow-up covered 1,793 patient-years. (Actuarial survival at 7 years was 76.6 +/- 3% for MVR. At 6 years, it was 83.2 +/- 2.8% for AVR and 55 +/- 13.5% for multiple valve replacement.) Prosthesis-related survival at 7 years was 91.7 +/- 1.9% for MVR, and at 6 years, it was 96.6 +/- 1.5% for AVR and 95.1 +/- 2.2% for multiple valve replacement. Bioprosthesis survival, considering deaths or complications that led to reoperation as final events, was 84.2 +/- 3.7% at 7 years for mitral valves and 87.7 +/- 3.8% at 6 years for aortic valves. Emboli per 100 patient-years numbered 3.2 for MVR, 0.5 for AVR, and 1.6 for multiple valve replacement. Twenty-seven patients underwent reoperation, 12 for perivalvular leak, 5 for endocarditis, 6 for valve thrombosis, and 4 for primary tissue failure (linearized rates of 0.7, 0.3, 0.3, and 0.2% per patient-year, respectively).(ABSTRACT TRUNCATED AT 250 WORDS)
回顾了1974年1月至1980年12月期间接受心脏瓣膜置换术的990例患者使用猪生物瓣膜的临床结果。共使用了874个汉考克生物瓣膜、283个卡彭蒂埃 - 爱德华兹生物瓣膜和10个利奥塔生物瓣膜。另外，23例患者还植入了26个机械瓣膜。990例患者中，总体手术死亡率为60例（6.06%）：二尖瓣置换术（MVR）506例中有30例（5.9%），主动脉瓣置换术（AVR）287例中有13例（4.5%），三尖瓣置换术4例中有1例（25%），肺动脉瓣置换术2例中无死亡，多瓣膜置换术191例中有16例（8.4%）。累积随访涵盖1793患者年。（MVR患者7年的精算生存率为76.6±3%。AVR患者6年的精算生存率为83.2±2.8%，多瓣膜置换术患者6年的精算生存率为55±13.5%。）MVR患者7年的假体相关生存率为91.7±1.9%，AVR患者6年的假体相关生存率为96.6±1.5%，多瓣膜置换术患者6年的假体相关生存率为95.1±2.2%。将导致再次手术的死亡或并发症视为最终事件，二尖瓣生物瓣膜7年的生存率为84.2±3.7%，主动脉瓣生物瓣膜6年的生存率为87.7±3.8%。MVR每100患者年的栓塞率为3.2，AVR为0.5，多瓣膜置换术为1.6。27例患者接受了再次手术，12例因瓣周漏，5例因心内膜炎，6例因瓣膜血栓形成，4例因原发性组织衰竭（每年每例患者的线性发生率分别为0.7%、0.3%、0.3%和0.2%）。（摘要截取自250字）
