Dunn J M
Ann Thorac Surg. 1981 Oct;32(4):357-68. doi: 10.1016/s0003-4975(10)61757-2.
Calcification of porcine heterograft valves may be greater in the pediatric than in the adult population. This multicenter study evaluates the long-term actuarially determined durability of porcine valves in children less than 21 years old. We evaluated 227 late survivors of porcine valve implantation with 47 aortic valves, 67 mitral valves, 14 tricuspid valves, 14 pulmonary valves, 77 pulmonary conduits, and 8 apicoaortic conduits. In this series, 20 porcine valves degenerated, most in the aortic and mitral positions. At 5 years 40% of aortic, 40% of mitral, 100% of tricuspid, 100% of pulmonary, and 89% of pulmonary conduits remained functional. In this series, calcification and dysfunction occurred significantly faster (p less than 0.05) in younger compared with older children and in left-sided or systemic positions (aortic and mitral) compared with right-sided positions (tricuspid, pulmonary, and pulmonary conduit).
猪异种移植瓣膜的钙化在儿科人群中可能比成人更严重。这项多中心研究评估了21岁以下儿童猪瓣膜经长期精算确定的耐用性。我们评估了227例猪瓣膜植入术后的晚期存活者,其中有47个主动脉瓣、67个二尖瓣、14个三尖瓣、14个肺动脉瓣、77个肺动脉导管和8个心尖主动脉导管。在这个系列中,20个猪瓣膜发生退变,大多数发生在主动脉瓣和二尖瓣位置。5年后,40%的主动脉瓣、40%的二尖瓣、100%的三尖瓣、100%的肺动脉瓣以及89%的肺动脉导管仍保持功能。在这个系列中,与年龄较大的儿童相比,年龄较小的儿童以及与右侧位置(三尖瓣、肺动脉瓣和肺动脉导管)相比,左侧或体循环位置(主动脉瓣和二尖瓣)的钙化和功能障碍发生得明显更快(p小于0.05)。