Starek P J, Murray G F, Keagy B A, Wilcox B R
Thorac Cardiovasc Surg. 1983 May;31 Spec 2:66-8. doi: 10.1055/s-2007-1022032.
One hundred seventy-two patients have had Medtronic-Hall pivoting disk valves implanted at the University of North Carolina since April, 1978 as a primary procedure or in combination with other cardiac surgery. One hundred twenty-three patients (31 combined) had aortic valves implanted, 32 patients (3 combined) had mitral valves implanted, and 17 patients (7 combined) had aortic and mitral valves implanted. The actuarial survival at 4 1/2 years, excluding the operative mortality, is 100% for all patients with mitral valve replacement and 91% for all patients with aortic valve replacement. The actuarial survival at 2 1/2 years for all patients with aortic and mitral valves replaced is 88%. None of the patients had clinical evidence of hemolysis. The average LDH value was 531 +/- 240 IU/L. Eighty percent of the surviving patients were totally asymptomatic, 19% were symptomatic with moderate exertion, and only 1% were unchanged or worse. Four cerebrovascular accidents occurred in this group of patients for a 1.1/100 patient years incidence of cerebrovascular accidents in the aortic group and a 3.8/100 patient years incidence in the mitral group. Two of the mitral valves were replaced because of thrombosis and one aortic valve was found to be thrombosed at autopsy in a late death for an incidence of 0.6/100 patient years in the aortic group and 3.8/100 patient years in the mitral group. Hemodynamic measurements performed intraoperatively showed that only the smallest valve size, #21, was somewhat stenotic, with the average valve area being 1.3 cm2 for that size. There were no structural valve failures observed in this group of patients.
自1978年4月以来，172例患者在北卡罗来纳大学接受了美敦力-霍尔旋转盘式瓣膜植入手术，该手术为主要术式或与其他心脏手术联合进行。其中，123例患者（31例为联合手术）植入了主动脉瓣，32例患者（3例为联合手术）植入了二尖瓣，17例患者（7例为联合手术）植入了主动脉瓣和二尖瓣。排除手术死亡率后，二尖瓣置换患者4年半的精算生存率为100%，主动脉瓣置换患者为91%。主动脉瓣和二尖瓣置换患者2年半的精算生存率为88%。所有患者均无溶血的临床证据。乳酸脱氢酶（LDH）平均水平为531±240 IU/L。80%的存活患者完全无症状，19%的患者在中度运动时有症状，只有1%的患者病情无变化或恶化。该组患者发生了4次脑血管意外，主动脉瓣组的脑血管意外发生率为1.1/100患者年，二尖瓣组为3.8/100患者年。二尖瓣组有2例因血栓形成而进行瓣膜置换，1例主动脉瓣在尸检时发现有血栓形成，发生在晚期死亡患者中，主动脉瓣组的发生率为0.6/100患者年，二尖瓣组为3.8/100患者年。术中进行的血流动力学测量显示，只有最小尺寸（#21）的瓣膜略有狭窄，该尺寸瓣膜的平均瓣口面积为1.3 cm²。该组患者未观察到瓣膜结构故障。
