Horstkotte D, Körfer R, Seipel L, Bircks W, Loogen F
Circulation. 1983 Sep;68(3 Pt 2):II175-84.
Valve-related complications after Björk-Shiley mitral valve implantation (n = 475), aortic valve implantation (n = 424), or mitral-aortic valve implantation (n = 119) were compared with those after St. Jude Medical mitral valve replacement (n = 173), aortic valve replacement (n = 152), or mitral-aortic valve replacement (n = 69). All patients were placed on anticoagulant therapy with phenprocoumon early after operation. All patients had a comparable follow-up time of approximately 23 months, which showed that cumulative thromboembolic rates were significantly higher after St. Jude valve implantation than after Björk-Shiley valve implantation. Reoperations were necessary because of valve thrombosis (0.46%), perivalvular leakage (2.2%), or prosthetic valve endocarditis with perivalvular regurgitation (0.46%). One Björk-Shiley mitral valve prosthesis had to be replaced because of fracture of the outlet strut. Without significant intergroup differences, hemorrhage due to anticoagulant treatment was the most frequent complication. Thromboembolic complications were significantly more frequent after Björk-Shiley mitral, aortic, and double valve replacements than after St. Jude valve implantation. This may lead to consideration of changes in the prophylaxis of thrombus formations in the St. Jude valve, especially in aortic valve replacements, in patients with sinus rhythm.
将接受 Björk-Shiley 二尖瓣植入术（n = 475）、主动脉瓣植入术（n = 424）或二尖瓣 - 主动脉瓣植入术（n = 119）后的瓣膜相关并发症与接受圣犹达医疗公司二尖瓣置换术（n = 173）、主动脉瓣置换术（n = 152）或二尖瓣 - 主动脉瓣置换术（n = 69）后的并发症进行比较。所有患者术后早期均接受苯丙香豆素抗凝治疗。所有患者的随访时间相近，约为 23 个月，结果显示圣犹达瓣膜植入术后的累积血栓栓塞率显著高于 Björk-Shiley 瓣膜植入术后。因瓣膜血栓形成（0.46%）、瓣周漏（2.2%）或人工瓣膜心内膜炎伴瓣周反流（0.46%）而需要再次手术。一枚 Björk-Shiley 二尖瓣假体因出口支柱断裂而必须更换。在无显著组间差异的情况下，抗凝治疗引起的出血是最常见的并发症。Björk-Shiley 二尖瓣、主动脉瓣和双瓣膜置换术后的血栓栓塞并发症比圣犹达瓣膜植入术后明显更频繁。这可能导致考虑改变圣犹达瓣膜血栓形成的预防措施，尤其是在窦性心律患者的主动脉瓣置换术中。
