Comparative analysis of mechanical and bioprosthetic valves after aortic valve replacement.
Comparative analysis of mechanical and bioprosthetic valves after aortic valve replacement.
复制标题
主动脉瓣置换术后机械瓣膜和生物瓣膜的比较分析。
DOI：
10.1016/s0022-5223(19)36314-7
复制
发表时间：
1987
期刊：
影响因子：
--
通讯作者：
B. Reitz
中科院分区：
文献类型：
--
作者：
A. Borkon;L. Soule;K. Baughman;H. Aoun;W. Baumgartner;T. Gardner;L. Watkins;V. Gott;B. Reitz
对1976年至1981年间接受主动脉瓣置换术的患者使用Björk-Shiley机械瓣膜和生物瓣膜的长期性能特征进行了比较分析。共有419例患者接受了标准Björk-Shiley（n = 266）或生物假体（猪，n = 126，或心包，n = 27）主动脉瓣。累积患者随访时间为1，705患者年;平均患者随访时间为4.1 ± 2.7年。除11例患者（97%完成随访）外，所有患者均获得了术后9年的生存数据。Björk-Shiley和生物瓣膜接受者的5年生存率为81% ± 4%（±标准误）。Björk-Shiley组的瓣膜失效主要是由于瓣膜相关死亡，而不是结构失效。植入生物瓣膜的患者因人工瓣膜心内膜炎和内在瓣膜退化而发生瓣膜失效。尽管生物瓣膜患者的瓣膜相关发病率低于Björk-Shiley瓣膜接受者（p < 0.03），但生物瓣膜和Björk-Shiley瓣膜之间的5年瓣膜相关死亡率或瓣膜失效发生率无差异。Björk-Shiley组的瓣膜失效死亡率（86%，12/14）高于生物瓣膜组（36%，5/14）（p < 0.01）。
Comparative long-term performance characteristics of Björk-Shiley mechanical and bioprosthetic valves were analyzed for patients undergoing aortic valve replacement between 1976 and 1981. A total of 419 patients received either a standard Björk-Shiley (n = 266) or bioprosthetic (porcine, n = 126, or pericardial, n = 27) aortic valve. Cumulative patient follow-up was 1,705 patient-years; the average patient follow-up was 4.1 ± 2.7 years. Survival data were obtained for all but 11 patients (97% complete follow-up) up to 9 years after operation. Survival at 5 years was 81% ± 4% (± standard error) for Björk-Shiley and for bioprosthetic valve recipients. Valve failure in the Björk-Shiley group was predominately due to valve-related mortality and did not result from structural failure. Patients with bioprosthetic valves experienced valve failure as a result of prosthetic valve endocarditis and intrinsic valve degeneration. Although patients with bioprostheses experienced a lower incidence of valve-related morbidity than Björk-Shiley valve recipients (p < 0.03), no difference could be demonstrated in the incidence of valve-related mortality or valve failure at 5 years between bioprosthetic and Björk-Shiley valves. Mortality rate from valve failure was higher for Björk-Shiley (86%, 12/14) than bioprosthetic valves (36%, 5/14) (p < 0.01).