Cachera J P, Laurent F, Poulain H, Loisance D, Bloch G, Galey J J
Nouv Presse Med. 1977 Feb 5;6(5):341-4.
A series of 230 mitral valve replacements using exclusively the Starr-Edwards ball valve prosthesis is presented. These 230 patients underwent surgery over a 4 year period, a uniform operative technique being used. Its essential feature was the use of a standardised technique for protection of the myocardium based upon continous clamping of the aorta and deep hypothermia at around 15 degrees. The technique of myocardial hypothermia, already reported, is briefly reviewed. The results are analysed, in the short and long term. Overall hospital mortality was 6.9 per cent, including multiple valve replacements and combined coronary surgery. The total number of thrombo-embolic complications was 8, including 1 early thrombosis out of 230 patients - i.e. 0.4 per cent and 7 late thrombo-embolic episodes out of 180 patients followed up for 1 month to 4 years - i.e. 3.8 per cent. Secondary and late mortality was 11 cases out of 180 patients. The survival rate at 4 years was 78 per cent by actuarial calculation, including operative mortality. These results justify the continued use of ball prosthesis, the long term thrombo-embolic risks of which are equal to or less than those of disc prosthesis, and the resistance of which to wear and tear is shown by the long postoperative survivals.
本文报告了一系列仅使用斯塔尔-爱德华兹球瓣假体进行的230例二尖瓣置换手术。这230例患者在4年期间接受了手术，采用了统一的手术技术。其基本特征是采用基于持续夹闭主动脉和15℃左右深度低温的标准化心肌保护技术。已报道的心肌低温技术在此作简要回顾。对短期和长期结果进行了分析。总体医院死亡率为6.9%，包括多瓣膜置换和联合冠状动脉手术。血栓栓塞并发症总数为8例，其中230例患者中有1例早期血栓形成，即0.4%，在随访1个月至4年的180例患者中有7例晚期血栓栓塞事件，即3.8%。180例患者中有11例发生继发性和晚期死亡。经精算计算，包括手术死亡率在内，4年生存率为78%。这些结果证明继续使用球瓣假体是合理的，其长期血栓栓塞风险等于或低于盘瓣假体，并且其术后长期存活表明其耐磨性能良好。
