Stein P D, Kemp S R, Riddle J M, Lee M W, Lewis J W, Magilligan D J
Ann Thorac Surg. 1985 Aug;40(2):175-80. doi: 10.1016/s0003-4975(10)60014-8.
The gross appearance of 54 spontaneously degenerated porcine bioprosthetic valves was evaluated to determine the relation of calcium deposition to cusp disruption. Tears or perforations were shown in 89% (48) of the degenerated valves. The most common site of tears or perforations was near the commissural attachment (60% of all tears). Grossly visible deposits of calcium salts that ruptured to the surface of the cusps or caused changes in the topography were observed in 70% (38) of the 54 valves. Calcification was adjacent to tears or perforations in 56% (27) of the 48 valves with torn cusps. Among the valves that showed calcification, the deposits of calcium salts were adjacent to tears or perforations in 71% (27 of 38). The location of deposits of calcium did not relate to the age or sex of the patient or to the position of the valve, but valves with calcium were inserted longer than valves with no calcium (87 +/- 4 versus 58 +/- 7 months; p less than 0.001). The outflow surfaces showed more calcification than the inflow surfaces, irrespective of whether the valves were in the aortic or mitral position. Among the 38 valves with calcification, 92% (35) showed calcification at the commissural attachments, 53% (20) showed calcification in the body of 1 or more cusps, 11% (4) near the base, and 8% (3) near the free edge. In conclusion, most patients with spontaneous porcine valve degeneration showed calcification. The calcification was associated with tears or perforations of the cusps in 50% of all degenerated valves, in 56% of valves with torn cusps, and in 71% of valves that showed gross calcification.
对54个自发退变的猪生物瓣膜的大体外观进行评估，以确定钙沉积与瓣叶破裂之间的关系。89%（48个）退变瓣膜出现撕裂或穿孔。撕裂或穿孔最常见的部位是在瓣叶联合附着处附近（占所有撕裂的60%）。在54个瓣膜中的70%（38个）观察到钙盐的大体可见沉积，这些沉积突破到瓣叶表面或引起表面形态改变。在48个瓣叶有撕裂的瓣膜中，56%（27个）的钙化与撕裂或穿孔相邻。在显示钙化的瓣膜中，71%（38个中的27个）的钙盐沉积与撕裂或穿孔相邻。钙沉积的位置与患者的年龄、性别或瓣膜位置无关，但有钙化的瓣膜植入时间比无钙化的瓣膜长（87±4个月对58±7个月；p<0.001）。无论瓣膜处于主动脉或二尖瓣位置，流出面的钙化都比流入面多。在38个有钙化的瓣膜中，92%（35个）在瓣叶联合附着处有钙化，53%（20个）在1个或多个瓣叶体部有钙化，11%（4个）在基部附近，8%（3个）在游离缘附近。总之，大多数猪瓣膜自发退变的患者出现钙化。在所有退变瓣膜的50%、瓣叶有撕裂的瓣膜的56%以及显示明显钙化的瓣膜的71%中，钙化与瓣叶的撕裂或穿孔相关。
