Gallo J I, Ruiz B, Carrion M F, Gutierrez J A, Vega J L, Duran C M
Ann Thorac Surg. 1981 May;31(5):444-9. doi: 10.1016/s0003-4975(10)60999-x.
All patients who had a mitral or aortic Hancock valve replacement between June, 1974, and June, 1979, were reviewed. A total of 734 bioprostheses were implanted in 632 patients: 291 had mitral (MVR), 239 had aortic (AVR), and 102 had both mitral and aortic valve replacement (MVR + AVR). In 228 patients, an associated surgical procedure was necessary. It involved conservative valve operation in 205 of them. The hospital mortality was 9.6% (28) for MVR (11.5% with associated operation), 4.6% (11) for AVR (8.7% with associated operation), and 13.7% (14) for MVR + AVR (13.0% with associated operation). The follow-up period was between 1 and 6 years with a total follow-up of 934.6, 714.6, and 288.3 patient-years for MVR, AVR and MVR + AVR, respectively. The late mortality was 0.96% (9), 1.53% (11), and 2.08% (6) per patient-year for MVR, AVR, and MVR + AVR, respectively. The thromboembolic rate was 1.49%, 0.14%, and 2.08% per patient-year for MVR, AVR, and MVR + AVR, respectively. There were twelve valve failure (six wer due to rupture; four, thrombosis; one, insufficiency because of intrinsic failure; and one, stenosis without evident cause at reoperation). This represents a failure rate of 0.53%, 0.13%, and 2.08% per patient-year for MVR, AVR, and MVR + AVR, respectively. These results encourage us to continue our routine use of the glutaraldehyde xenografts as the safest valve substitute at present.
对1974年6月至1979年6月期间接受二尖瓣或主动脉瓣汉考克瓣膜置换术的所有患者进行了回顾性研究。632例患者共植入了734个生物假体：291例进行了二尖瓣置换术（MVR），239例进行了主动脉瓣置换术（AVR），102例同时进行了二尖瓣和主动脉瓣置换术（MVR + AVR）。228例患者需要进行相关的外科手术。其中205例进行了保守性瓣膜手术。MVR的医院死亡率为9.6%（28例）（联合手术时为11.5%），AVR为4.6%（11例）（联合手术时为8.7%），MVR + AVR为13.7%（14例）（联合手术时为13.0%）。随访时间为1至6年，MVR、AVR和MVR + AVR的总随访时间分别为934.6、714.6和288.3患者年。MVR、AVR和MVR + AVR的晚期死亡率分别为每年0.96%（9例）、1.53%（11例）和2.08%（6例）。血栓栓塞率分别为MVR每年1.49%、AVR每年0.14%、MVR + AVR每年2.08%。有12例瓣膜功能衰竭（6例因破裂；4例因血栓形成；1例因自身功能衰竭导致关闭不全；1例在再次手术时无明显原因出现狭窄）。这分别代表MVR、AVR和MVR + AVR每年的故障率为0.53%、0.13%和2.08%。这些结果鼓励我们继续常规使用戊二醛异种移植物作为目前最安全的瓣膜替代品。
