He Meng, Zhang Jinwei, Yu Jianbo, Gao Xiaoqing, Ren Changwei, Lai Yongqiang, Cui Hao
Department of Cardiovascular Surgery, Beijing Anzhen Hospital, Capital Medical University Beijing, China.
Beijing Institute of Heart, Lung and Blood Vessel Diseases Beijing, China.
Card Fail Rev. 2025 May 19;11:e12. doi: 10.15420/cfr.2024.40. eCollection 2025.
For patients eligible for both mechanical and bioprosthetic valves, postoperative quality of life (QOL) is a key factor in determining the type of prosthetic valve used.
We reviewed patients aged 60-65 years who underwent isolated aortic valve replacement at our centre. Postoperative QOL was assessed through a telephone follow-up using the 36-item Short Form Health Survey questionnaire.
A total of 628 valid survey responses were collected, comprising 353 patients with mechanical valves and 275 with bioprosthetic valves. The mean age of the patients was 62.5 ± 1.7 years, and 363 (57.8%) were men. The mean follow-up period was 7.3 ± 3.9 years. There were no significant differences in any QOL subscale or the overall 36-item Short Form Health Survey score between patients with mechanical and bioprosthetic valves. BMI (β=-0.109, p=0.014) and postoperative time (β=-0.251, p<0.001) were the independent predictors of QOL, after adjusting for factors, such as age at the time of surgery, sex, ejection fraction, type of prosthesis and prosthesis effective orifice area index. The rates of stroke and cardiovascular reintervention per patient-year were similar between the two groups. However, in those 12 years after aortic valve replacement, mechanical valves seemed to perform better.
In patients aged 60-65 years undergoing isolated aortic valve replacement, there is no significant difference in postoperative QOL between those receiving mechanical or bioprosthetic valves, but mechanical valves seemed to perform better in the late period.
对于有资格使用机械瓣膜和生物瓣膜的患者，术后生活质量（QOL）是决定使用何种人工瓣膜类型的关键因素。
我们回顾了在我们中心接受单纯主动脉瓣置换术的60 - 65岁患者。术后生活质量通过使用36项简短健康调查问卷进行电话随访来评估。
共收集到628份有效调查问卷回复，其中353例患者使用机械瓣膜，275例使用生物瓣膜。患者的平均年龄为62.5±1.7岁，363例（57.8%）为男性。平均随访期为7.3±3.9年。使用机械瓣膜和生物瓣膜的患者在任何生活质量子量表或总体36项简短健康调查问卷得分上均无显著差异。在调整手术时年龄、性别、射血分数、人工瓣膜类型和人工瓣膜有效瓣口面积指数等因素后，BMI（β=-0.109，p = 0.014）和术后时间（β=-0.251，p<0.001）是生活质量的独立预测因素。两组患者每年的中风和心血管再干预发生率相似。然而，在主动脉瓣置换术后的12年中，机械瓣膜似乎表现更好。
在接受单纯主动脉瓣置换术的60 - 65岁患者中，接受机械瓣膜或生物瓣膜的患者术后生活质量无显著差异，但机械瓣膜在后期似乎表现更好。
