Anderson E T, Hancock E W
J Thorac Cardiovasc Surg. 1976 Jul;72(1):150-6.
The long-term results of aortic valve replacement with the fresh aortic homograft, performed in 114 patients at Stanford University Medical Center from 1967 to 1971, were evaluated. There were 10 operative deaths (8.8 per cent), only 3 (5 per cent) in the period from 1968 to 1971. There were 6 late deaths in the first year (5.8 per cent) and 8 in later years (1.5 per cent per year); 12 late deaths were due to cardiac causes, 6 of them to valve dysfunction. The homograft was replaced later with a prosthetic valve or heterograft in 22 patients (3.2 per cent per year): for regurgitation in 20 and for calcific stenosis in only one. Infective endocarditis occurred in 5 cases, accounting for one operative death, 2 late deaths, and 2 reoperations with survival. Systemic thromboembolism occurred in 6 patients, 3 with mitral valve disease, one with atrial fibrillation, and one with infective endocarditis; none was a proved instance of embolism from bland thrombus on the aortic homograft valve. Of 53 patients followed for 5 years or more with the homograft intact, 47 have minimal or no disability, despite aortic diastolic murmurs in many. We conclude that long-term results are good in the majority of patients, with aortic regurgitation requiring reoperation being the leading complication. These results may serve as a basis for comparison of more recently introduced methods of aortic valve replacement.
对1967年至1971年在斯坦福大学医学中心为114例患者施行新鲜主动脉同种异体瓣膜置换术的长期结果进行了评估。手术死亡10例（8.8%），1968年至1971年期间仅3例（5%）。第一年有6例晚期死亡（5.8%），随后几年有8例（每年1.5%）；12例晚期死亡归因于心脏原因，其中6例是由于瓣膜功能障碍。22例患者（每年3.2%）后来用人工瓣膜或异种移植物替换了同种异体瓣膜：20例是因为反流，仅1例是因为钙化性狭窄。发生感染性心内膜炎5例，导致1例手术死亡、2例晚期死亡以及2例再次手术存活。6例患者发生全身性血栓栓塞，3例患有二尖瓣疾病，1例患有心房颤动，1例患有感染性心内膜炎；没有一例被证实是主动脉同种异体瓣膜上的单纯血栓引起的栓塞。在53例同种异体瓣膜完整且随访5年或更长时间的患者中，47例仅有轻微残疾或无残疾，尽管许多患者有主动脉舒张期杂音。我们得出结论，大多数患者的长期结果良好，主动脉反流需要再次手术是主要并发症。这些结果可作为比较最近引入的主动脉瓣膜置换方法的基础。
