索林倾斜盘式机械瓣膜假体在二尖瓣和主动脉瓣位置的长期临床性能。

Hurle A, Abad C, Feijoo J, Ray V, Ponce G

Department of Cardiovascular Surgery, Hospital N. S. del Pino, Las Palmas de Gran Canaria, Canary Islands, Spain.

J Cardiovasc Surg (Torino). 1997 Oct;38(5):507-12.

OBJECTIVE

Analyzing the long term performance of sorin tilting-disc mechanical prostheses.

EXPERIMENTAL DESIGN

Retrospective patient-oriented study. The total follow-up was 460.2 patient-years. Follow-up data was obtained from the patients themselves or from their relatives.

SETTING

Department of Cardiovascular Surgery in a general community hospital.

PATIENTS

Seventy four patients undergoing valve replacement with Sorin tilting-disc mechanical prostheses between May, 1982 and July 1991.

INTERVENTIONS

Thirty one of those patients underwent isolated mitral valve replacement (MVR) and 43 isolated aortic valve replacement (AVR).

MEASURES

The incidence of the different complications is expressed as linearized rates. Actuarial analysis was performed with the Kaplan-Meier method.

RESULTS

Linearized rates for MVR and AVR for the different complications (events per 100 patient-years) were, respectively: Late mortality: 4.5 +/- 1.6 and 1.8 +/- 0.8; Thromboembolism: 3.4 +/- 1.4 and 1.1 +/- 0.6; Anticoagulant-related hemorrhage: 2.8 +/- 1.3 and 0.3 +/- 0.3; Prosthetic endocarditis: 1.1 +/- 0.8 and 0.7 +/- 0.5; Non-structural dysfunction: 0.5 +/- 0.5 and 1.1 +/- 0.6; Reoperation: 1.1 +/- 0.8 and 0.3 +/- 0.3. Actuarial probabilities of freedom from the different complications were, respectively, at 13 years follow-up for MVR and 12 years follow-up for AVR, the following: Late mortality: 45.7 +/- 12.4% and 70.3 +/- 7.9%; Thromboembolism: 74.6 +/- 10.8% and 90.7 +/- 5.1%; Anticoagulant-related hemorrhage: 79.4 +/- 11.6% and 97.3 +/- 2.7%; Prosthetic endocarditis: 92.7 +/- 4.9% and 91.2 +/- 6.4%; Non-structural dysfunction: 95.6 +/- 4.3% and 88.2 +/- 6.6%; Reoperation: 83.6 +/- 11.8% and 97.3 +/- 2.7%. All valve-related mortality and morbidity: 42.2 +/- 11.0% and 56.7 +/- 8.6%. There was no instances of prosthetic structural failure.

CONCLUSIONS

The Sorin mechanical prosthesis presents a good durability and its performance in the long term is comparable to other tilting-disc devices of the same generation.

目的

分析索林倾斜盘式机械瓣膜的长期性能。

实验设计

以患者为导向的回顾性研究。总随访时间为460.2患者年。随访数据来自患者本人或其亲属。

研究地点

一家普通社区医院的心血管外科。

患者

1982年5月至1991年7月期间接受索林倾斜盘式机械瓣膜置换术的74例患者。

干预措施

其中31例患者接受单纯二尖瓣置换术（MVR），43例接受单纯主动脉瓣置换术（AVR）。

测量指标

不同并发症的发生率以线性化率表示。采用Kaplan-Meier法进行精算分析。

结果

MVR和AVR不同并发症的线性化率（每100患者年的事件数）分别为：晚期死亡率：4.5±1.6和1.8±0.8；血栓栓塞：3.4±1.4和1.1±0.6；抗凝相关出血：2.8±1.3和0.3±0.3；人工瓣膜心内膜炎：1.1±0.8和0.7±0.5；非结构性功能障碍：0.5±0.5和1.1±0.6；再次手术：1.1±0.8和0.3±0.3。在MVR随访13年和AVR随访12年时，不同并发症的无事件精算概率分别为：晚期死亡率：45.7±12.4%和70.3±7.9%；血栓栓塞：74.6±10.8%和90.7±5.1%；抗凝相关出血：79.4±11.6%和97.3±2.7%；人工瓣膜心内膜炎：92.7±4.9%和91.2±6.4%；非结构性功能障碍：95.6±4.3%和88.2±6.6%；再次手术：83.6±11.8%和97.3±2.7%。所有与瓣膜相关的死亡率和发病率：42.2±11.0%和56.7±8.6%。未发生人工瓣膜结构性故障。