Long-term results of bioprosthetic mitral valve replacement: the pericardial perspective.
Long-term results of bioprosthetic mitral valve replacement: the pericardial perspective.
复制标题
生物二尖瓣置换术的长期结果：心包视角。
DOI：
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发表时间：
2004
影响因子：
1.4
通讯作者：
T. David
中科院分区：
文献类型：
--
作者：
T. Doenst;M. Borger;T. David
心包生物瓣膜在20世纪70年代初问世，并在80年代得到广泛应用。Ionescu-Shiley瓣膜是第一种商用心包瓣膜，其长期效果令人失望，因为在植入后的第一个十年中，尖端撕裂的发生率很高。汉考克心包瓣膜的过早衰竭进一步阻碍了人们对这种生物瓣膜的热情。1981年引进的Carpentier-Edwards心包瓣膜置换主动脉瓣的远期疗效表明，该瓣膜经久耐用，并通过适当的设计解决了尖端撕裂的问题。这一知识促使外科医生重新审视心包瓣膜用于二尖瓣置换术的优点，目前已有其他几种心包瓣膜上市。有关长期结果的最大数据是Carpentier-Edwards心包二尖瓣。在平均年龄为60到70岁的患者群体中，报告的10年内结构瓣膜衰竭的发生率从69%到85%不等。年轻是瓣膜衰竭的主要决定因素，这主要是由于钙化造成的。也有长期的数据，尽管更多的是关于用于二尖瓣置换的Sorin PericCarbon和Mitroflow瓣膜。本文回顾了近30年来国内外在二尖瓣置换术中应用各种心包生物瓣膜的经验。
Pericardial valve bioprostheses were introduced in early 1970s and were widely used in the 1980s. The longterm results with the Ionescu-Shiley valve, the first commercially available pericardial valve, were disappointing because of high rate cusp tears during the first decade after implantation. The enthusiasm for this type of bioprosthetic valve was further hampered by the premature failure of the Hancock pericardial valve. The long-term results of aortic valve replacement with the Carpentier-Edwards pericardial valve, which was introduced in 1981, indicated that that valve was durable and the issue of cusp tears had been resolved by an appropriate design. This knowledge prompted surgeons to revisit the merits of pericardial valves for mitral valve replacement and several other pericardial valves are now commercially available. The largest data on long-term results are with the Carpentier-Edwards pericardial mitral valve. The reported freedom from structure valve failure ranged from 69% to 85% at 10 years in patient population with mean age of 60 to 70 years. Young age is a major determinant of valve failure, which is largely due to calcification. There are also long-term data, albeit more limited on the Sorin Pericarbon and Mitroflow valves used for mitral valve replacement. This paper review the published experience with various pericardial bioprosthetic valves used for mitral valve replacement during the past 3 decades.