Nitter-Hauge S, Abdelnoor M, Svennevig J L
Medical Department B, Rikshospitalet, University of Oslo, Norway.
Circulation. 1996 Nov 1;94(9 Suppl):II105-8.
The Medtronic-Hall valvular prosthesis was used for the first time in Oslo, Norway, in June 1977. During the 10-year period from 1977 through 1987, the valve was the valve of choice in Oslo and was implanted in a total of 1104 consecutive patients with mean age of 56 years. There were 816 aortic (AVR), 187 mitral (MVR), and 101 combined mitral and aortic (DVR) valve replacements.
We report our 15-year experience with this prosthesis in a total of 1090 patients (98.7% complete follow-up). The observation time ranged from 7 to 17.8 years (mean, 9.2 years), with cumulative follow-up representing 10016 patient-years. Actuarial survival, including both early and late deaths, was 46% after AVR, 42% after MVR, and 28% after DVR. Thromboembolism occurred at linearized rates of 1.8%, 1.9%, and 1.9% per patient-year after AVR, MVR, and DVR, respectively. There were eight cases of valvular thrombosis, one fatal, resulting in linearized rates of 0.05%, 0.19%, and 0.13% per patient-year after AVR, MVR, and DVR, respectively. There were no instances of structural valve failure. Morbidity from anticoagulant-related hemorrhage was 1.19% per patient-year, with seven fatal events, all of cerebral origin.
Excellent long-term outcomes were confirmed for patients, with 80% of survivors in New York Heart Association class I or II.
美敦力-霍尔瓣膜假体于1977年6月在挪威奥斯陆首次使用。在1977年至1987年的10年期间，该瓣膜是奥斯陆的首选瓣膜，共连续植入1104例患者，平均年龄56岁。其中主动脉瓣置换术（AVR）816例，二尖瓣置换术（MVR）187例，二尖瓣和主动脉瓣联合置换术（DVR）101例。
我们报告了在1090例患者中使用这种假体的15年经验（98.7%的患者获得完整随访）。观察时间为7至17.8年（平均9.2年），累积随访时间为10016患者年。包括早期和晚期死亡在内的精算生存率，AVR术后为46%，MVR术后为42%，DVR术后为28%。AVR、MVR和DVR术后每患者年的血栓栓塞线性发生率分别为1.8%、1.9%和1.9%。有8例瓣膜血栓形成，1例致命，导致AVR、MVR和DVR术后每患者年的线性发生率分别为0.05%、0.19%和0.13%。没有结构性瓣膜失效的情况。抗凝相关出血的发病率为每患者年1.19%，有7例致命事件，均源于脑部。
患者的长期预后良好，80%的幸存者纽约心脏协会心功能分级为I级或II级。
