Munro A I, Jamieson W R, Burr L H, Ling H, Miyagishima R T, Germann E
Division of Cardiovascular and Thoracic Surgery, University of British Columbia, Vancouver, Canada.
Ann Thorac Surg. 1995 Aug;60(2 Suppl):S459-62; discussion S463. doi: 10.1016/0003-4975(95)00305-5.
The performance of porcine bioprostheses and mechanical prostheses in multiple valve replacement operations was evaluated in 494 patients with 553 operations between 1975 and 1992. Porcine bioprostheses were implanted in 351 multiple replacement operations and 202 operations were performed with mechanical prostheses. The mean age of the bioprosthesis group was 59.1 +/- 14.4 years and of the mechanical prostheses group, 55.9 +/- 13.3 years. Concomitant procedures, primarily coronary artery bypass grafting, were performed in 27.4% (96 patients) of the bioprosthesis group and 20.8% (42 patients) of the mechanical prosthesis group (p = not significant [NS]). The early mortality for the bioprosthesis group (BP) was 12.0% (42 patients), whereas for the mechanical prosthesis (MP) group it was 10.9% (22 patients) with no difference (p = NS) for the performance with or without concomitant procedures, primarily coronary artery bypass grafting. The total cumulative follow-up was 1,914 years for BP and 458 years for MP group. The late mortality was different between the groups (p < 0.05), 6.1%/patient-year for BP and 3.7%/patient-year for MP. The difference in late mortality was not different (p = NS) for performance of concomitant procedures and not different (p = NS) for the absence of concomitant procedures, 5.6%/patient-year for BP and 2.2%/patient-year for MP. The freedom from thromboembolism- and antithromboembolic-related hemorrhage favored the biological population (p < 0.05) at 10 years with 79.7% +/- 3.4% for BP and 75.4% +/- 5.0% for MP. The freedom from structural valve deterioration was 100% for MP, whereas for the BP group, 94.7% +/- 1.6% at 5 years and 65.9% +/- 4.3% at 10 years.(ABSTRACT TRUNCATED AT 250 WORDS)
1975年至1992年间，对494例患者进行了553次手术，评估了猪生物瓣膜和机械瓣膜在多次瓣膜置换手术中的性能。在351次多次置换手术中植入了猪生物瓣膜，202次手术使用了机械瓣膜。生物瓣膜组的平均年龄为59.1±14.4岁，机械瓣膜组为55.9±13.3岁。生物瓣膜组27.4%（96例患者）和机械瓣膜组20.8%（42例患者）进行了主要为冠状动脉旁路移植术的同期手术（p=无显著差异[NS]）。生物瓣膜组（BP）的早期死亡率为12.0%（42例患者），而机械瓣膜（MP）组为10.9%（22例患者），无论有无同期手术（主要是冠状动脉旁路移植术），其性能无差异（p=NS）。BP组的总累积随访时间为1914年，MP组为458年。两组的晚期死亡率不同（p<0.05），BP组为6.1%/患者年，MP组为3.7%/患者年。同期手术的晚期死亡率差异无统计学意义（p=NS），无同期手术时差异也无统计学意义（p=NS），BP组为5.6%/患者年，MP组为2.2%/患者年。在10年时，无血栓栓塞和抗血栓栓塞相关出血方面，生物瓣膜组更具优势（p<0.05），BP组为79.7%±3.4%，MP组为75.4%±5.0%。机械瓣膜无结构瓣膜退化的发生率为100%，而BP组在5年时为94.7%±1.6%，10年时为65.9%±4.3%。（摘要截短于250字）
