Lemieux M D, Jamieson W R, Landymore R W, Dumesnil J G, Métras J, Munro A I, Raymond G, Tyers G F, Cartier P C, Ali I M
Laval University, Quebec, Canada.
Ann Thorac Surg. 1995 Aug;60(2 Suppl):S258-63. doi: 10.1016/0003-4975(95)00268-p.
The clinical performance of the Medtronic Intact porcine bioprosthesis was evaluated in 1,084 patients (mean age 66.4 years, range 9 to 91 years) who had a total of 1,099 implantations between 1985 and 1992, inclusive. There were 709 aortic valve replacements, 297 mitral valve replacements, and 80 multiple valve replacements. Concomitant procedures were performed in 432 (39.3%). The age group distribution (years) was 35 or younger in 20 patients, 36 to 50 in 64, 51 to 64 in 274, 65 to 69 in 225, 70 or older in 500. The total follow-up time was 2,741 patient-years (mean, 2.5 years) and was 97.5% complete. The early mortality rate was 7.1% and late mortality was 3.9% per patient-year. The overall patient survival at 7 years was 70% +/- 3%. The freedom from major thromboembolism was 94% +/- 1% at 7 years (p = not significant for valve positions). The freedom from reoperation at 7 years was 93% +/- 1%; freedom from valve-related mortality was 89% +/- 2%. The freedom from structural valve deterioration at 7 years was 97% +/- 1% (aortic valve replacement 97% +/- 1%; mitral valve replacement 97% +/- 2%). The freedom from structural valve deterioration among age groups was not different for the overall population, aortic valve replacement, or mitral valve replacement. Hemodynamic assessment revealed obstructive properties for aortic valve replacement sizes of 21 and 23 mm and for mitral valve replacement sizes of 25 and 27 mm.(ABSTRACT TRUNCATED AT 250 WORDS)
对美敦力完整猪生物假体的临床性能进行了评估,研究对象为1985年至1992年(含)期间共植入1099次的1084例患者(平均年龄66.4岁,范围9至91岁)。其中主动脉瓣置换709例,二尖瓣置换297例,多瓣膜置换80例。432例(39.3%)患者进行了同期手术。年龄组分布(岁)为:35岁及以下20例,36至50岁64例,51至64岁274例,65至69岁225例,70岁及以上500例。总随访时间为2741患者年(平均2.5年),随访完成率为97.5%。早期死亡率为7.1%,晚期死亡率为每年3.9%。7年时总体患者生存率为70%±3%。7年时无重大血栓栓塞的概率为94%±1%(瓣膜位置差异无统计学意义)。7年时无需再次手术的概率为93%±1%;无瓣膜相关死亡的概率为89%±2%。7年时无瓣膜结构恶化的概率为97%±1%(主动脉瓣置换为97%±1%;二尖瓣置换为97%±2%)。各年龄组间无瓣膜结构恶化的情况在总体人群、主动脉瓣置换或二尖瓣置换中无差异。血流动力学评估显示,主动脉瓣置换尺寸为21和23毫米以及二尖瓣置换尺寸为25和27毫米时具有梗阻性。(摘要截取自250字)