Mid-term comparative follow-up after aortic valve replacement with Carpentier-Edwards and Pericarbon pericardial prostheses.
Mid-term comparative follow-up after aortic valve replacement with Carpentier-Edwards and Pericarbon pericardial prostheses.
复制标题
使用 Carpentier-Edwards 和 Pericarbon 心包假体进行主动脉瓣置换术后的中期比较随访。
DOI：
10.1161/01.cir.100.suppl_2.ii-11
复制
发表时间：
1999
期刊：
影响因子：
37.8
通讯作者：
H. Warembourg
中科院分区：
文献类型：
--
作者：
T. Tourneau;C. Savoye;E. Mcfadden;D. Grandmougin;H. Carton;J. Hennequin;A. Dubar;G. Fayad;H. Warembourg
背景
第一代心包瓣膜的过早退化率很高。本研究的目的是比较主动脉瓣置换术后与第二代心包假体（Corpebon和Carpentier-Edwards）的结局。
方法和结果
在1987年至1994年期间，162例患者接受了主动脉瓣置换术，使用了Alabbon（n=81，69+/-11岁）或Carpentier-Edwards（n=81，70+/-11岁）心包假体。平均随访时间为4.4+/-2.7年，Carpentier-Edwards瓣膜为4.8+/-2.4年（P=0. 001）。27），总随访时间为745患者年。30天死亡率和5年精算生存率分别为6.2%和63.2+/-5.7%，Carpentier-Edwards组分别为6.2%和63.5+/-5.6%。8年时，无血栓栓塞、结构性失效和所有瓣膜相关事件的发生率（和每患者年的线性化发生率）分别为91.8 ± 3.6%（1.4%）、76. Risebon组为94.4 +/-8.7%（2.5%）和58.4+/-9.3%（5.6%），Carpentier-Edwards组为94.4+/-2.7%（1%）、100%（0%，P<0.01）和88.8+/-3.7%（2%，P<0.05）。有9例（11.1%）股骨结构失效，主要与严重钙化和狭窄相关。Rippon组中纤维钙化变性（n=3）、假体周围漏（n=1）、心内膜炎（n = 1）和主动脉夹层（n =1）的实际再手术率为7.4%（1.6%/患者-年）。Carpentier-Edwards组无结构性瓣膜失效或瓣膜再次手术。对85名幸存者（82.3%）中的70名患者进行的超声心动图审查发现，另外4名患者有早期结构失效迹象，但没有Carpentier-Edwards瓣膜出现此类变化。
结论
主动脉瓣置换术后8年，与Carpentier-Edwards心包假体相比，Rippon心包假体的效果不佳，结构性瓣膜失效和再次手术的发生率较高。
BACKGROUND
The first generation of pericardial valves had a high rate of premature deterioration. The aim of this study was to compare the outcome after aortic valve replacement with second generation pericardial prostheses (Pericarbon and Carpentier-Edwards).
METHODS AND RESULTS
Between 1987 and 1994, 162 patients underwent aortic valve replacement with either a Pericarbon (n=81, 69+/-11 years) or a Carpentier-Edwards (n=81, 70+/-11 years) pericardial prosthesis. Mean follow-up was 4.4+/-2.7 years for Pericarbon and 4.8+/-2.4 years for Carpentier-Edwards valves (P=0. 27), giving a total follow-up of 745 patient-years. Thirty-day mortality and 5-year actuarial survival were, respectively, 6.2% and 63.2+/-5.7% in the Pericarbon group and 6.2% and 63.5+/-5.6% in the Carpentier-Edwards group. At 8 years, freedom from (and linearized rates per patient-year) thromboembolism, structural failure, and all valve-related events were, respectively, 91.8+/-3.6% (1.4%), 76. 9+/-8.7% (2.5%), and 58.4+/-9.3% (5.6%) in the Pericarbon group and 94.4+/-2.7% (1%), 100% (0%, P<0.01), and 88.8+/-3.7% (2%, P<0.05) in the Carpentier-Edwards group. There were 9 (11.1%) Pericarbon structural failures related predominantly to severe calcification and stenosis. The actual reoperation rate was 7.4% (1.6% per patient-year) in the Pericarbon group for fibrocalcific degeneration (n=3), periprosthetic leak (n=1), endocarditis (n=1), and aortic dissection (n=1). There was neither structural valve failure nor valve reoperation in the Carpentier-Edwards group. Echocardiographic review of 70 patients from 85 survivors (82.3%) found 4 additional Pericarbon valves with signs of early structural failure but no Carpentier-Edwards valve with such changes.
CONCLUSIONS
Eight years after aortic valve replacement, Pericarbon pericardial prostheses compared unfavorably with Carpentier-Edwards pericardial prostheses, with a high incidence of structural valve failure and reoperation.