Reichenspurner H, Weinhold C, Nollert G, Kaulbach H G, Vetter H O, Boehm D H, Reichart B
Department of Cardiac Surgery, Klinikum Grosshadern, Ludwig-Maximilians University, Munich, Germany.
Thorac Cardiovasc Surg. 1995 Feb;43(1):19-26. doi: 10.1055/s-2007-1013763.
In order to evaluate selective differences of biological porcine valves versus pericardial valves and to analyze various valve models, 8 different bioprostheses (4 porcine valves, 4 pericardial valves) were studied in a 12-year follow-up. From 1978 to 1990, 476 porcine bioprostheses (Carpentier-Edwards: n = 104, Carpentier Edwards Supraanular: n = 59, Hancock I: n = 41, Hancock II: n = 272) and 647 pericardial valves (Hancock-Extracorporeal: n = 479, Ionescu-Shiley: n = 76, Carpentier-Edwards: n = 57, Mitroflow: n = 35) were implanted. At time of implantation, the patient age ranged from 21-85 years, mean 57.1 +/- 12.4 years. 831 patients were analyzed in the long-term follow-up (62.3 +/- 18.6 months, cumulative follow-up of 6632 patient-years). The incidences of thromboembolic complications (TE), endocarditis (E), primary tissue failure (PTF), rate of reoperation (ReOp), and late mortality due to prosthesis dysfunction were analyzed, calculated, and compared within the different valve models (actuarial data, chi 2 test, log rank analysis). The incidences of TE and E were lower for pericardial valves when compared with porcine bioprostheses (TE: 0.88 vs. 1.8%/patient year; E: 0.24 vs. 0.5%/patient year); within the 2 groups, the different valve models did not show any major differences. However, the incidence of PTF was significantly higher in the pericardial valve group, being 36 +/- 6.5%, 68 +/- 10% and 86 +/- 19.5% after 6, 8, and 10 years; the respective figures for the porcine valves were 6 +/- 3.5%, 18 +/- 7.1%, and 60 +/- 13.1% (p < 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)
为了评估生物猪瓣膜与心包瓣膜的选择性差异，并分析各种瓣膜模型，在12年的随访中研究了8种不同的生物假体（4个猪瓣膜，4个心包瓣膜）。从1978年到1990年，植入了476个猪生物假体（卡朋蒂埃-爱德华兹：n = 104，卡朋蒂埃爱德华兹瓣上型：n = 59，汉考克I型：n = 41，汉考克II型：n = 272）和647个心包瓣膜（汉考克体外型：n = 479，约内斯库-希利型：n = 76，卡朋蒂埃-爱德华兹型：n = 57，米特罗弗洛型：n = 35）。植入时，患者年龄在21至85岁之间，平均为57.1±12.4岁。对831例患者进行了长期随访（62.3±18.6个月，累积随访6632患者年）。分析、计算并比较了不同瓣膜模型中的血栓栓塞并发症（TE）、心内膜炎（E）、原发性组织衰竭（PTF）、再次手术率（ReOp）以及因假体功能障碍导致的晚期死亡率（精算数据、卡方检验、对数秩分析）。与猪生物假体相比，心包瓣膜的TE和E发生率较低（TE：0.88对1.8%/患者年；E：0.24对0.5%/患者年）；在两组中，不同的瓣膜模型未显示出任何重大差异。然而，心包瓣膜组的PTF发生率显著更高，6年、8年和10年后分别为36±6.5%、68±10%和86±19.5%；猪瓣膜的相应数字分别为6±3.5%、18±7.1%和60±13.1%（p < 0.001）。（摘要截断于250字）
