Aupart M, Hammami S, Sirinelli A, Dreyfus X, Meurisse Y, Marchand M
Unité de Chirurgie Cardiaque, Hôpital Trousseau, TøURS.
Ann Chir. 1996;50(5):367-73.
Between July 1984 and December 1993. 110 patients, younger than 60 years, underwent aortic valve replacement with a Carpentier-Edwards pericardial valve. 75.5% were male, with a mean age of 49.6 years (range: 16 to 59 years). Mean clinical status was 2.25. Operative mortality was 0%. All patients but 3 were followed up with a total follow-up of 454 patient-years and an average of 4.8 years. The 10-year actuarial survival is 91 +/- 6%. We observed 8 valve-related complications (1.7% patient-years): 3 cases of endocarditis, 3 structural failures, 1 thromboembolic event, and 1 perivalvular leak. 1 patient died from a valve-related cause, and 2 reoperations were necessary. The 8-year actuarial probability of absence of valve-related death is 99 +/- 1%, thromboembolism 98 +/- 2%, endocarditis 96 +/- 4%; reoperations 96 +/- 4%, and valve failure 97 +/- 3%. The 10-year valve-related complication rate is satisfactory, but the durability of the prosthesis in this group of young patients remains unknown. A longer follow-up is mandatory to draw definitive conclusions.
1984年7月至1993年12月期间，110名年龄小于60岁的患者接受了Carpentier-Edwards心包瓣膜主动脉瓣置换术。75.5%为男性，平均年龄49.6岁（范围：16至59岁）。平均临床状况评分为2.25。手术死亡率为0%。除3例患者外，所有患者均接受了随访，总随访时间为454患者年，平均随访4.8年。10年精算生存率为91±6%。我们观察到8例瓣膜相关并发症（1.7%患者年）：3例心内膜炎、3例结构故障、1例血栓栓塞事件和1例瓣周漏。1例患者死于瓣膜相关原因，2例需要再次手术。无瓣膜相关死亡的8年精算概率为99±1%，血栓栓塞为98±2%，心内膜炎为96±4%；再次手术为96±4%，瓣膜故障为97±3%。10年瓣膜相关并发症发生率令人满意，但该组年轻患者人工瓣膜的耐久性仍不清楚。必须进行更长时间的随访才能得出明确结论。
