Thomson R, Yacoub M, Ahmed M, Somerville W, Towers M
J Thorac Cardiovasc Surg. 1980 Jun;79(6):896-903.
Between August, 1969 and May 1978, 679 patients underwent homograft replacement of the aortic valve. Isolated elective valve replacement was performed in 411 patients. Thirty-four patients had total aortic root replacement with reimplantation of the coronary arteries. There were 16 early deaths (3.9%) and 43 late deaths (10.5%) during a follow-up between 3 and 102 months (mean 47 months). Actuarial analysis showed 87% survival at 5 years and 81% at 8 years. Valve failure occurred in 24 patients (5.9%) owing to prolapse of one cusp in eight patients (2.0%), infective endocarditis in seven patients (1.7%), and degeneration of the valve in nine patients (2.2%). Degenerative valve failure was encountered after the fourth year with an incidence of 4.8% of patients at risk and occurred only in grafts from donors over the age of 65 years. Diastolic murmurs were present in 28% of patients followed beyond 1 month and increased very slightly with time. Systemic embolism was not recorded in any patient despite the fact that anticoagulants were not used. The clinical results were judged to be good or excellent in 89% of patients. It is concluded that homograft replacement of the aortic valve gives satisfactory results with a low incidence of late valve failure.
1969年8月至1978年5月期间，679例患者接受了主动脉瓣同种异体移植置换术。411例患者接受了单纯择期瓣膜置换术。34例患者进行了主动脉根部全置换并冠状动脉再植术。在3至102个月（平均47个月）的随访期间，有16例早期死亡（3.9%）和43例晚期死亡（10.5%）。精算分析显示，5年生存率为87%，8年生存率为81%。24例患者（5.9%）发生瓣膜功能衰竭，其中8例患者（2.0%）因一个瓣叶脱垂，7例患者（1.7%）因感染性心内膜炎，9例患者（2.2%）因瓣膜退变。瓣膜退变导致的功能衰竭在第四年后出现，发生率为有风险患者的4.8%，且仅发生在65岁以上供体的移植物中。超过1个月随访的患者中有28%存在舒张期杂音，且随时间略有增加。尽管未使用抗凝剂，但未记录到任何患者发生系统性栓塞。89%的患者临床结果判定为良好或极佳。结论是，主动脉瓣同种异体移植置换术效果满意，晚期瓣膜功能衰竭发生率低。
