Fiore A C, Swartz M T, Sharp T G, Kesler K A, Barner H B, Naunheim K S, Grunkemeier G L, Moroney D A, Kaiser G C
Division of Cardiothoracic Surgery, St. Louis University Health Sciences Center, Missouri 63110-0250, USA.
Ann Thorac Surg. 1995 May;59(5):1113-8; discussion 1119. doi: 10.1016/0003-4975(95)00123-3.
To define better the performance of the bileaflet St. Jude and the tilting-disc Medtronic-Hall valves, we retrospectively analyzed 122 patients (St. Jude, 80 patients; Medtronic-Hall, 42 patients) who received simultaneous aortic and mitral replacement from May 1984 until June 1994. The two groups were not different with respect to preoperative clinical and hemodynamic parameters and New York Heart Association functional class. The hospital mortality and late mortality were not significantly different. Risk analysis identified advanced age and previous myocardial revascularization as predictors of operative death. Follow-up was complete in 96 of 103 hospital survivors (93%) and was similar in both groups. The actuarial survival, linearized rates of valve-related complications, and actuarial freedom from valve-related complications were similar in both cohorts. The presence of coronary artery disease negatively influenced the actuarial survival after simultaneous aortic and mitral valve replacement. Postoperative New York Heart Association functional class was not significantly different in either group. These data indicate that the Medtronic-Hall and St. Jude prostheses are not significantly different with respect to their clinical performance and valve-related complications for simultaneous double-valve replacement.
为了更准确地界定双叶型圣犹达瓣膜和倾斜碟片美敦力-霍尔瓣膜的性能，我们回顾性分析了1984年5月至1994年6月期间接受同期主动脉瓣和二尖瓣置换术的122例患者（圣犹达瓣膜组80例患者；美敦力-霍尔瓣膜组42例患者）。两组患者在术前临床和血流动力学参数以及纽约心脏协会心功能分级方面并无差异。住院死亡率和晚期死亡率也无显著差异。风险分析确定高龄和既往心肌血运重建是手术死亡的预测因素。103例住院幸存者中有96例（93%）完成了随访，两组情况相似。两个队列的精算生存率、瓣膜相关并发症的线性发生率以及无瓣膜相关并发症的精算自由度相似。冠状动脉疾病的存在对同期主动脉瓣和二尖瓣置换术后的精算生存率有负面影响。两组术后纽约心脏协会心功能分级均无显著差异。这些数据表明，对于同期双瓣膜置换术，美敦力-霍尔瓣膜和圣犹达瓣膜在临床性能和瓣膜相关并发症方面并无显著差异。
