Vrandecic M P, Gontijo B F, Fantini F A, Gutierrez C, Paula e Silva J A, Oliveira O C, Barbosa J T, Oliveira R M, Avelar S O, Miotto H C
Department of Cardiothoracic Surgery, Biocor Institute, Belo Horizonte, Minas Gerais, Brazil.
Cardiovasc Surg. 1994 Jun;2(3):407-14.
From May 1990 to August 1993, 100 patients underwent aortic valve replacement using the stentless porcine aortic valve. There were 69 males and 31 females. The mean age was 36 (range 11-76) years. Of 70 patients under 40 years of age, 20 were less than 20 years old. Indications included rheumatic heart sequelae in 55 patients (first valve replacement), prosthetic failure in 20, endocarditis in 13, congenital aortic bicuspid valve in four, degenerative disease in four and senile calcified aortic valves in four. Twenty patients had aortic annular related pathology. There were 15 associated surgical procedures. Forty-three patients required aortic root enlargement. There were approximately equal numbers of patients in New York Heart Association (NYHA) functional classes III and IV. The hospital mortality rate was 6%; 14 patients who experienced hospital morbidity had a full recovery. Two late reoperations were performed in patients with primary valve endocarditis; their recovery was uneventful. Four late deaths were not valve related. Comparative echo Doppler analysis before and after operation demonstrated good improvement of left ventricular function in nearly all patients. The valve was competent in 96% of patients and the remainder displayed minor jets without haemodynamic significance. The valve coaptation was stable in all patients. Use of the stentless porcine aortic valve in this first 100 patients has provided excellent clinical results with a follow-up of 41 months. Further follow-up and close observation will be required to analyse the outcome of this new valve and procedure with time.
1990年5月至1993年8月，100例患者接受了无支架猪主动脉瓣置换术。其中男性69例，女性31例。平均年龄为36岁（范围11 - 76岁）。在70例40岁以下的患者中，20例年龄小于20岁。手术适应证包括风湿性心脏后遗症55例（首次瓣膜置换）、人工瓣膜功能障碍20例、心内膜炎13例、先天性主动脉瓣二叶瓣4例、退行性疾病4例和老年性钙化主动脉瓣4例。20例患者存在主动脉瓣环相关病变。有15例联合手术。43例患者需要扩大主动脉根部。纽约心脏协会（NYHA）心功能Ⅲ级和Ⅳ级的患者数量大致相等。医院死亡率为6%；14例发生医院并发症的患者完全康复。2例原发性瓣膜心内膜炎患者进行了晚期再次手术，恢复顺利。4例晚期死亡与瓣膜无关。手术前后的对比超声多普勒分析显示，几乎所有患者的左心室功能都有明显改善。96%的患者瓣膜功能良好，其余患者显示轻微反流束，无血流动力学意义。所有患者的瓣膜对合稳定。在这首批100例患者中使用无支架猪主动脉瓣，随访41个月取得了优异的临床效果。需要进一步随访和密切观察，以分析这种新瓣膜和手术方法随时间推移的结果。
