Twenty year comparison of a Bjork-Shiley mechanical heart valve with porcine bioprostheses
Twenty year comparison of a Bjork-Shiley mechanical heart valve with porcine bioprostheses
复制标题
DOI：
10.1136/heart.89.7.715
复制
发表时间：
2003-07-01
期刊：
影响因子：
5.7
通讯作者：
Miller, HC
中科院分区：
文献类型：
--
作者：
Oxenham, H;Bloomfield, P;Miller, HC
目的：比较接受机械或生物瓣心脏瓣膜假体的患者的生存率和结局。设计：随机前瞻性试验。设置：三级心脏中心。患者：1975年至1979年，患者随机接受Bjork-Shiley或猪假体。261例患者接受了二尖瓣置换，211例患者接受了主动脉瓣置换，61例患者接受了两种瓣膜置换。结果：20年后，存活率没有差异（Bjork-Shiley对猪假体（平均值（SEM））：25.0（2.7）%对22.6（2.7）%，对数秩检验p=0.39）。91例猪瓣膜患者和22例Bjork-Shiley瓣膜患者因瓣膜失效进行了再次手术。一项结合死亡和再次手术作为终点的分析证实，Biork-Shiley患者在原始假体完整的情况下生存率提高（23.5（2.6）% v6.7（1.6）%，对数秩检验p
Objective: To compare survival and outcome in patients receiving a mechanical or bioprosthetic heartvalve prosthesis.Design: Randomised prospective trial.Setting: Tertiary cardiac centre.Patients: Between 1975 and 1979, patients were randomised to receive either a Bjork-Shiley or a porcine prostheses. The mitral valve was replaced in 261 patients, the aortic in 211, and both valves in 61 patients. Follow up now averages 20 years.Main outcome measures: Death, reoperation, bleeding, embolism, and endocarditis.Results: After 20 years there was no difference in survival (Bjork-Shiley v porcine prosthesis (mean (SEM)): 25.0 (2.7)% v 22.6 (2.7)%, log rank test p=0.39). Reoperation for valve failure was undertaken in 91 patients with porcine prostheses and in 22 with Bjork-Shiley prostheses. An analysis combining death and reoperation as end points confirmed that Biork-Shiley patients had improved survival with the original prosthesis intact (23.5 (2.6)% v 6.7 (1.6)%, log rank test p