目的總結(jié)分析異種生物瓣膜置換術(shù)的臨床應(yīng)用結(jié)果,評價生物瓣膜在心臟外科中的應(yīng)用效果和趨勢。方法回顧性分析 2004年 7月至 2008年 7月在中國醫(yī)科大學(xué)附屬第一醫(yī)院接受異種生物瓣膜置換術(shù)患者 206例的臨床資料,男 157例,女 49例;年齡 44~ 79(64.7±13.2)歲。置換生物瓣膜 227枚,聯(lián)合置換機械瓣膜 11枚;同期行冠狀動脈旁路移植術(shù)( CABG)51例,房 /室間隔缺損修補術(shù) 7例。結(jié)果術(shù)后早期( 30 d內(nèi))死亡 7例。院外隨訪 6個月~ 5年,平均隨訪 23個月,隨訪 134例,隨訪率 67.3% ( 134/199)。隨訪患者心功能均得到不同程度的改善,未發(fā)現(xiàn)瓣周漏、感染性心內(nèi)膜炎、血栓和出血等并發(fā)癥。彩色多普勒超聲心動圖提示生物瓣膜功能良好,無明顯衰敗跡象。結(jié)論異種生物瓣膜置換療效確切,并發(fā)癥少,近期效果較好。
引用本文: 房勤,谷天祥,劉波等. 206例心臟生物瓣膜臨床應(yīng)用分析. 中國胸心血管外科臨床雜志, 2012, 19(3): 326-328. doi: 復(fù)制
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12. | Gammie JS, Sheng S, Griffith BP, et al. Trends in mitral valve surgery in the United States:results from the Society of Thoracic Surgeons adult cardiac database. Ann Thorac Surg, 2009, 87 (5):1437-1439. |
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- 1. El Oakley R, Kleine P, Bach DS. Choice of prosthetic heart valve in today’s practice. Circulation, 2008, 117 (2):253-256.
- 2. Colli A, Verhoye JP, Heijmen R, et al. Antithrombotic therapy after bioprosthetic aortic valve replacement:ACTION Registry survey results. Eur J Cardiothorac Surg, 2008, 33 (4):531-536.
- 3. Salem DN, Stein PD, Al-Ahmad A, et al. Antithrombotic therapy in valvular heart disease--native and prosthetic:the Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy. Chest, 2004, 126 (3 Suppl):457S-482S.
- 4. David TE, Armstrong S, Maganti M. Hancock II Bioprosthesis for aortic valve replacement:The gold standard of bioprosthetic valves durability? Ann Thoracic Surg , 2010, 90 (3):775-781.
- 5. 彭勇, 郭應(yīng)強, 張爾永. 牛心包生物瓣膜的臨床應(yīng)用. 中國胸心血管外科臨床雜志, 2007, 14 (2):144-146.
- 6. Gao G, Wu Y, Grunkemeier GL, et al. Durability of pericardial versus porcine aortic valves. J Am Coll Cardiol, 2004, 44 (2):384-388.
- 7. Stassano P, Di Tommaso L, Monaco M, et al. Aortic valve replacement:A prospective randomized evaluation of mechanical versus biological valves in patients ages 55 to 70 years. J Am Coll Cardiol , 2009, 54 (20):1862-1868.
- 8. Koertke H, Minami K, Boethig D, et al. INR self-management permits lower anticoagulation levels after mechanical heart valve replacement. Circulation, 2003, 108 (Suppl 1):Ⅱ75-78.
- 9. Salem DN, O’Gara PT, Madias C, et al. Valvular and structural heart disease:American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition). Chest, 2008, 133 (6 Suppl):593 S-629 S.
- 10. Marenchino RG, Nikisch LE, Diodato LH, et al. Mid-term follow-up of patients submitted to aortic valve replacement with mechanical prosthesis. Rev Argent Cardiol, 2008, 76 (3):187-192.
- 11. Koertke H, Zittermann A, Tenderich G, et al. Low-dose oral anticoagulation in patients with mechanical heart valve prostheses:final report from the early self-management anticoagulation trial II. Eur Heart J, 2007, 28 (20):2479-2484.
- 12. Gammie JS, Sheng S, Griffith BP, et al. Trends in mitral valve surgery in the United States:results from the Society of Thoracic Surgeons adult cardiac database. Ann Thorac Surg, 2009, 87 (5):1437-1439.
- 13. Sadler L, McCowan L, White H, et al. Pregnancy outcomes and cardiac complications in women with mechanical, bioprosthetic and homograft valves. BJOG, 2000, 107 (2):245-253.