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单纯二尖瓣置换术后的长期临床结局

Long term clinical outcomes following isolated mitral valve replacement.

作者信息

Haraphongse M, Na-Ayudhya R K, Williams R, Teo K K, Bay K S, Humen D, Gelfand E, Modry D, Callaghan J C, Montague T

机构信息

Division of Cardiology, University of Alberta Hospitals, Edmonton.

出版信息

Can J Cardiol. 1993 Jun;9(5):417-22.

PMID:8348393
Abstract

OBJECTIVE

This study reviews the short and long term outcomes of patients who underwent isolated mitral valve replacement at the University of Alberta Hospitals during the past decade.

DESIGN

Data were obtained retrospectively by review of patients' hospital charts, cardiologists' follow-up charts, contact with patients' physicians, and direct telephone or mail contact with patients and/or their surviving relatives.

RESULTS

The clinical outcomes of 198 consecutive patients (124 women and 74 men) who underwent isolated mitral valve replacement from January 1981 to December 1990 at the University of Alberta Hospital were reviewed. Overall early operative mortality was 11%. Deaths were mainly related to pump failure and previous mitral valve replacement. Late mortality was 17%. Follow-up data were available except in five patients. Average follow-up was 6.3 years. Overall cumulative survival was 72.9 +/- 3.4% at five years and 63.1 +/- 4.8% at 10 years. The cumulative freedom from complications was 64.3 +/- 3.9% and 36.4 +/- 4.9% at five and 10 years, respectively. Long term survival rates obtained after isolated mitral valve replacement are higher than those reported in series of medically treated patients with mitral valve disease.

CONCLUSIONS

Mitral valve replacement can prolong survival as well as improve symptoms in patients with symptomatic mitral valve disease.

摘要

目的

本研究回顾了过去十年间在阿尔伯塔大学医院接受单纯二尖瓣置换术患者的短期和长期预后情况。

设计

通过查阅患者的医院病历、心脏病专家的随访记录、与患者医生联系以及直接通过电话或邮件与患者和/或其在世亲属联系,回顾性获取数据。

结果

对1981年1月至1990年12月在阿尔伯塔大学医院接受单纯二尖瓣置换术的198例连续患者(124名女性和74名男性)的临床预后进行了回顾。总体早期手术死亡率为11%。死亡主要与泵衰竭和既往二尖瓣置换术有关。晚期死亡率为17%。除5例患者外,均有随访数据。平均随访时间为6.3年。五年时总体累积生存率为72.9±3.4%,十年时为63.1±4.8%。五年和十年时无并发症的累积自由度分别为64.3±3.9%和36.4±4.9%。单纯二尖瓣置换术后获得的长期生存率高于二尖瓣疾病药物治疗系列报道中的生存率。

结论

二尖瓣置换术可延长有症状二尖瓣疾病患者的生存期并改善症状。

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