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[15例儿童猪生物瓣置换术后随访研究]

[Follow-up study of porcine bioprosthetic valve replacement in 15 children].

作者信息

He J G, Zhang J F, Luo Z X

机构信息

Guangdong Provincial People's Hospital, Guangdong Provincial Cardiovascular Institute, Guangzhou.

出版信息

Zhonghua Wai Ke Za Zhi. 1994 Jul;32(7):424-6.

PMID:7842983
Abstract

GD-I porcine bioprosthetic valve replacement were performed in 15 cases from Jul. 1978 to Nov. 1982. Pathology: RHD 11, CHD 4, 13 with MVR, 1 AVR, 1 TVR. One patient died during operation (operative mortality 6.7%). 13 cases were followed up for 3-10 years: in the early years the symptoms and cardiac function were greatly improved and the size reduced. However dysfunction of bioprosthetic valve was detected 2-8 years after operation in 12 patients (19.37%/patient year). The main cause of damage and dysfunction of porcine valve is calcification of the leaflet. As compared with the adult group(dysfunction rate 3.6%/patient year) in this institute, more calcification of the porcine valve in children is considered because of: (1) stronger metabolism of calcium in children, (2) less mobility of the leaflet due to lower cardiac output in children, and (3) stronger immunoreaction to porcine valve in children.

摘要

1978年7月至1982年11月,对15例患者施行GD-I型猪生物瓣膜置换术。病理情况:风湿性心脏病11例,先天性心脏病4例;二尖瓣置换术13例,主动脉瓣置换术1例,三尖瓣置换术1例。1例患者于手术中死亡(手术死亡率6.7%)。13例患者随访3至10年:早期症状及心功能明显改善,心脏大小缩小。然而,12例患者(每年每患者19.37%)在术后2至8年检测到生物瓣膜功能障碍。猪瓣膜损坏及功能障碍的主要原因是瓣叶钙化。与本单位成人组(每年每患者功能障碍发生率3.6%)相比,儿童猪瓣膜钙化较多被认为是由于:(1)儿童钙代谢较强;(2)儿童心输出量较低导致瓣叶活动度较小;(3)儿童对猪瓣膜的免疫反应较强。

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