Kashyap Nitin Kumar, Mehsare Pranay, Saurabh Gaind Kumar, Chakraborty Nirupam, Singha Subrat, Wasnik Minal, Jain Sneha
Department of CTVS, All India Institute of Medical Sciences, GE Road, Tatibandh Square, Raipur, Chhattisgarh 492099 India.
Department of Anesthesia, AIIMS, Raipur, India.
Indian J Thorac Cardiovasc Surg. 2025 Apr;41(4):420-425. doi: 10.1007/s12055-024-01851-1. Epub 2024 Nov 8.
This study evaluates the performance of the Miltonia bi-leaflet mechanical prosthesis for mitral valve replacement (MVR).
Fifty patients were included in this study who underwent MVR using cardiopulmonary bypass (CPB) and mild hypothermia. After surgery, standard postoperative care was provided. Echocardiography was performed preoperatively, postoperatively at discharge, and at a 6-month follow-up to assess hemodynamic performance and detect adverse events.
The mean age was 38.88 ± 9.51 years, with a predominance of female patients. The average hospital stay was 9.6 ± 3.8 days. Before surgery, 88% of patients were in New York Heart Association (NYHA) class III, 8% in class IV, and 4% in class II. Post-surgery, 92% improved to class I, 4% to class II ( < 0.001). Both mean and peak pressure gradients showed significant improvement post-procedure ( < 0.001) and at 6 months ( < 0.001) compared to pre-operative status. At the 6-month follow-up, there were no cases of prosthetic valve endocarditis, structural/non-structural valve deterioration, dysfunction, or paravalvular leaks, with a 4% mortality rate. Four patients were diagnosed with prosthetic heart valve thrombosis (PHVT) during follow-up period of 6 months.
The Miltonia valve showed excellent hemodynamic performance and significant improvement in NYHA functional class.
本研究评估米尔顿尼亚双叶机械瓣膜用于二尖瓣置换术（MVR）的性能。
本研究纳入了50例接受体外循环（CPB）和轻度低温下二尖瓣置换术的患者。术后提供标准的术后护理。术前、出院时及6个月随访时进行超声心动图检查，以评估血流动力学性能并检测不良事件。
平均年龄为38.88±9.51岁，女性患者居多。平均住院时间为9.6±3.8天。术前，88%的患者为纽约心脏协会（NYHA）Ⅲ级，8%为Ⅳ级，4%为Ⅱ级。术后，92%改善为Ⅰ级，4%改善为Ⅱ级（P<0.001）。与术前状态相比，平均和峰值压力梯度在术后（P<0.001）及6个月时（P<0.001）均有显著改善。在6个月随访时，无人工瓣膜心内膜炎、结构性/非结构性瓣膜退化、功能障碍或瓣周漏的病例，死亡率为4%。在6个月的随访期内，有4例患者被诊断为人工心脏瓣膜血栓形成（PHVT）。
米尔顿尼亚瓣膜显示出优异的血流动力学性能，NYHA功能分级有显著改善。
