Vrandecic M, Gontijo B F, Fantini F A, Oliveira O C, Martins I C, Oliveira M H, Avelar S O, Vrandecic E, Vrandecic E
Department of Cardiothoracic Surgery, Biocor Institute, Belo Horizonte, MG, Brazil.
J Cardiovasc Surg (Torino). 1994 Dec;35(6 Suppl 1):41-5.
Beginning March 1992 to February 1994, 65 patients were submitted to mitral valve replacement using the porcine mitral stentless heart valve. This group took in 65 patients, their age ranged from four to 65 with a mean of 26 years. Forty patients were below years of age. The major indication was rheumatic heart disease sequelae in 50 patients, mitral valve endocarditis in six, myomatous degeneration in four and in five previous mitral prosthetic valve was replaced due to tissue failure. The preoperative functional class revealed 35 patients in class III and 30 in class IV. The longest follow-up was 23 months with a mean of 12. The surgical technique used rendered consistent and reproducible results. There was a hospital mortality of two patients or 3.1%. The hospital morbidity revealed full recovery of all patients. There were three patients reoperated because of valve endocarditis in two and in one due to partial dehiscence of the suture at the annular level. All three patients had full recovery after a reoperation. There was a late mortality of two patients, non valve related. The follow-up of these patients revealed full competent stentless mitral valve in 50 patients and in nine minor to mild jets were encountered by color echo-Doppler. Most patients are in functional class I and II. The stenless concept has prove to be outstanding in the mitral position throughout the current follow-up of close to 2 years.(ABSTRACT TRUNCATED AT 250 WORDS)
从1992年3月至1994年2月,65例患者接受了猪二尖瓣无支架心脏瓣膜置换术。该组共有65例患者,年龄从4岁至65岁不等,平均年龄为26岁。40例患者年龄在15岁以下。主要适应证为风湿性心脏病后遗症50例,二尖瓣心内膜炎6例,黏液样变性4例,5例因人工二尖瓣组织损坏而进行再次置换。术前心功能分级显示,Ⅲ级35例,Ⅳ级30例。最长随访时间为23个月,平均随访时间为12个月。所采用的手术技术取得了一致且可重复的结果。有2例患者(3.1%)在医院死亡。医院发病率显示所有患者均完全康复。有3例患者再次手术,2例因瓣膜心内膜炎,1例因瓣环水平缝线部分裂开。所有3例患者再次手术后均完全康复。有2例患者晚期死亡,与瓣膜无关。对这些患者的随访显示,50例患者的无支架二尖瓣功能完全正常,9例患者经彩色超声多普勒检查发现有轻微至轻度反流。大多数患者的心功能分级为Ⅰ级和Ⅱ级。在近2年的随访中,无支架瓣膜的理念在二尖瓣位置表现出色。(摘要截选至250字)