Pellerin M, Mihaileanu S, Couëtil J P, Relland J Y, Deloche A, Fabiani J N, Jindani A, Carpentier A F
Department of Cardiovascular Surgery, Hôpital Broussais, Paris, France.
Ann Thorac Surg. 1995 Aug;60(2 Suppl):S292-5; discussion S295-6. doi: 10.1016/0003-4975(95)00225-a.
Aortic valve replacement with Carpentier-Edwards pericardial bioprosthesis was associated with excellent midterm clinical results. Long-term evaluation, however, remained to be determined. We reviewed the first 124 patients who underwent aortic valve replacement with a Carpentier-Edwards bioprosthesis at the Hôpital Broussais between 1980 and 1985. There were 67 males (54%) and 57 females (46%). The mean age at operation was 65 years (range, 18-83 years). The operative mortality (30 days) was 4%. All but 2 patients were followed up for an average of 7.7 years and a total of 973 patient years. There were 45 late deaths (4.7%/patient-year) of which 16 were valve-related (1.7%/patient-year). The actuarial survival rate was 49.9% at 12 years. The actuarial rate for freedom from valve-related mortality was 78.3% at 12 years. There were 7 thromboembolic events in 5 patients and 3 anticoagulation-related hemorrhages. Freedom from structural valve deterioration was 100% at 12 years and 83.3% at 13 years. We conclude that implantation of Carpentier-Edwards pericardial bioprosthesis in aortic position is associated with an excellent long-term clinical outcome. It is believed that the improved results of this valve result from the following original features: fully flexible stent, distensible struts, infrastent tissue mounting, optimal tissue orientation, and improved preservation.
采用Carpentier-Edwards心包生物瓣膜进行主动脉瓣置换术的中期临床效果极佳。然而，长期评估仍有待确定。我们回顾了1980年至1985年间在布鲁赛医院接受Carpentier-Edwards生物瓣膜主动脉瓣置换术的首批124例患者。其中男性67例（54%），女性57例（46%）。手术时的平均年龄为65岁（范围18 - 83岁）。手术死亡率（30天）为4%。除2例患者外，所有患者平均随访7.7年，总计973患者年。有45例晚期死亡（4.7%/患者年），其中16例与瓣膜相关（1.7%/患者年）。12年时的精算生存率为49.9%。12年时无瓣膜相关死亡的精算率为78.3%。5例患者发生7次血栓栓塞事件，3例与抗凝相关的出血。12年时无结构性瓣膜退变的比例为100%，13年时为83.3%。我们得出结论，在主动脉位置植入Carpentier-Edwards心包生物瓣膜具有极佳的长期临床结果。据信，该瓣膜效果改善源于以下独特特征：完全可弯曲的支架、可扩张的支柱、支架内组织固定、最佳组织取向以及改进的保存方法。
