Peronace B, Cornelli U, Marcazzan E, Pellegrini A
G Ital Cardiol. 1980;10(8):1024-30.
285 patients who underwent aortic valve replacement between 1972 and 1977 have been studied. 197 patients had a Starr-Edwards prosthesis and 88 patients had a Björk-Shiley prosthesis, both groups presented similar risk factors. The follow-up varied between a period of 6 months minimum and 72 months maximum, the mean period is 3.6 years. The statistical results have been realized based on the multi-factor analysis (cluster) which were the basis to define the homogeneous groups of patients with the Starr prosthesis and the Björk prosthesis. One may observe the best survival percentage after 72 months from surgery date in patients with the Björk prosthesis comparing them with those patients who underwent aortic valve replacement with the Starr prosthesis (resp. 93 and 71%). The difference is important from the statistical point of view. The embolic incidence after such a period is nearly equal (16% for Björk and 14% for Starr). The cluster analysis of the considered parameters (age, duration of symptoms before surgery, NYHA class, C/T) did not evince real and proper risk factors such to condition, at long term, the results even if differences in mortality and in embolic incidence, with regards to the relation with NYHA class and symptoms; duration, have been observed. One may conclude that one of most important risks derives form the type of used prosthesis.
对1972年至1977年间接受主动脉瓣置换术的285例患者进行了研究。197例患者使用了斯塔尔-爱德华兹人工瓣膜,88例患者使用了比约克-希利人工瓣膜,两组呈现出相似的风险因素。随访时间最短为6个月,最长为72个月,平均时间为3.6年。统计结果基于多因素分析(聚类)得出,这些分析是定义使用斯塔尔人工瓣膜和比约克人工瓣膜患者同质性组别的基础。与接受斯塔尔人工瓣膜主动脉瓣置换术的患者相比,可以观察到使用比约克人工瓣膜的患者在术后72个月时的生存率最高(分别为93%和71%)。从统计学角度来看,这种差异很显著。在这段时间后的栓塞发生率几乎相等(比约克人工瓣膜为16%,斯塔尔人工瓣膜为14%)。对所考虑参数(年龄、术前症状持续时间、纽约心脏协会分级、C/T)的聚类分析并未显示出真正合适的风险因素,这些因素能够长期影响结果,尽管在死亡率和栓塞发生率方面,就与纽约心脏协会分级和症状持续时间的关系而言,已观察到差异。可以得出结论,最重要的风险之一源于所使用人工瓣膜的类型。