Rooney S J, Moreno de la Santa P, Lewis P A, Butchart E G
Department of Cardiac Surgery, University Hospital of Wales, Cardiff, UK.
J Heart Valve Dis. 1994 Jan;3(1):5-9.
In order to test the validity of the current guidelines on the categorization of non-autopsied sudden death after valve replacement, a detailed analysis was undertaken of 412 deaths in a large single-institution prosthetic series based on one type of prosthesis (Medtronic Hall) over a 13-year period. Of 69 sudden or unwitnessed deaths, 48 (70%) were autopsied. There were no sudden deaths specifically related to the prosthesis itself, 79% of deaths were due to coronary disease or left ventricular dysfunction and 10% were due to intracranial hemorrhage. Overall, 90% of sudden deaths were unrelated to the prosthesis A seasonal fluctuation in the incidence of sudden and unwitnessed deaths was demonstrated in keeping with the known epidemiology of sudden death in the general population. It was concluded that there was no evidence to support the recommendation that all non-autopsied sudden deaths should be attributed to the prosthesis.
为了检验当前关于瓣膜置换术后非尸检猝死分类指南的有效性，我们对一家大型单机构假体系列中13年间基于一种假体（美敦力霍尔）的412例死亡病例进行了详细分析。在69例猝死或未被目击的死亡病例中，48例（70%）进行了尸检。没有猝死与假体本身直接相关，79%的死亡是由于冠状动脉疾病或左心室功能障碍，10%是由于颅内出血。总体而言，90%的猝死与假体无关。猝死和未被目击死亡的发生率呈现季节性波动，这与普通人群中已知的猝死流行病学情况相符。研究得出结论，没有证据支持将所有非尸检猝死都归因于假体的建议。
