Abdulali S A, Silverton N P, Schoen F J, Saunders N R, Ionescu M I
Ann Thorac Surg. 1984 Dec;38(6):579-85. doi: 10.1016/s0003-4975(10)62314-4.
Eighty patients who underwent mitral valve replacement (MVR) with Braunwald-Cutter prostheses (54, single valve replacement; 26, multiple valve replacement) between December, 1972, and September, 1975, are discussed. The period of follow-up ranged from 72 to 120 months with a mean of 84.6 months. For the hospital survivors, actuarial survival at ten years was 73 +/- 6.7% for patients with MVR alone and 30 +/- 17.5% for those with multiple valve replacement. The linearized rate of embolic complications in patients with MVR was 3.2% per year and in patients with multiple valve replacement, 1.5% per year. These low rates of embolism allow a favorable comparison of the Braunwald-Cutter valve with other mechanical prostheses. There was no evidence of serious poppet wear or poppet escape after ten years of the valve in the mitral and tricuspid positions. Thus, elective replacement of the Braunwald-Cutter valve from the atrioventricular position because of this potential problem is not considered necessary. In the aortic position, escape of the poppet from the valve has occurred as late as 101 months. The overall morbidity for the group was high. Only 34% of the patients having MVR and 12% of those with multiple valve replacement are expected to be alive and to remain free from any major complication ten years after operation.
本文讨论了1972年12月至1975年9月期间接受布劳恩瓦尔德-卡特人工瓣膜二尖瓣置换术（MVR）的80例患者（54例为单瓣膜置换；26例为多瓣膜置换）。随访时间为72至120个月，平均84.6个月。对于医院幸存者，单纯二尖瓣置换术患者10年的精算生存率为73±6.7%，多瓣膜置换患者为30±17.5%。二尖瓣置换术患者的栓塞并发症线性发生率为每年3.2%，多瓣膜置换患者为每年1.5%。这些低栓塞率使得布劳恩瓦尔德-卡特瓣膜与其他机械瓣膜相比具有优势。二尖瓣和三尖瓣位置的瓣膜使用十年后，没有严重的提动盘磨损或提动盘脱出的证据。因此，由于这个潜在问题而从房室位置选择性更换布劳恩瓦尔德-卡特瓣膜被认为没有必要。在主动脉位置，提动盘最晚在101个月时从瓣膜脱出。该组患者的总体发病率较高。预计二尖瓣置换术患者中只有34%以及多瓣膜置换患者中只有12%在术后十年还活着且没有任何重大并发症。
