Windsor H M, Shanahan M X, Chang V P
Med J Aust. 1979 Jul 28;2(2):53-6. doi: 10.5694/j.1326-5377.1979.tb112701.x.
A 15-year experience (from 1963-1978) in cardiac valve replacements with mechanical prosthetic valves (caged ball or tilting disc types) and with bioprostheses (porcine xenografts) is reported. The actuarial survival rates for patients who received the caged ball type prostheses (Starr-Edwards) were 42% and 36% respectively for mitral valve-replacements at 12 and 14 years. The actuarial survival rate for patients who received the tilting disc type prostheses (Björk-Shiley type and later the Lillehei-Kaster type) was 74% at six to seven years. The actuarial survival rate for patients who had aortic valve replacement with a caged ball valve was 43% at 14 years, and for those who had a tilting disc valve it was 80% at six to seven years. Multiple valve replacements were carried out with combinations of prostheses. The actuarial survival rate for patients was 65% for triple valves, and 57% for double valves at 13 years. Bioprostheses are now our first choice as cardiac valve replacements. In 121 implants performed since 1977, there have been two operative deaths, but no late deaths. Bioprostheses, although less thrombogenic than mechanical valve prostheses, are less durable and some risk of thromboembolism remains.
本文报告了1963年至1978年15年间使用机械人工心脏瓣膜（笼球型或倾斜碟型）和生物瓣膜（猪异种移植物）进行心脏瓣膜置换的经验。接受笼球型人工瓣膜（斯塔尔-爱德华兹型）的患者，二尖瓣置换术后12年和14年的精算生存率分别为42%和36%。接受倾斜碟型人工瓣膜（比约克-希利型及后来的 Lillehei-Kaster 型）的患者，六至七年后的精算生存率为74%。接受笼球型主动脉瓣置换的患者，14年时的精算生存率为43%，而接受倾斜碟型瓣膜置换的患者，六至七年后的精算生存率为80%。采用不同类型人工瓣膜组合进行了多瓣膜置换。三瓣膜置换患者13年的精算生存率为65%，双瓣膜置换患者为57%。生物瓣膜目前是我们心脏瓣膜置换的首选。自1977年以来进行的121例植入手术中，有2例手术死亡，但无晚期死亡。生物瓣膜虽然比机械瓣膜血栓形成倾向小，但耐久性较差，仍存在一定的血栓栓塞风险。
