生物瓣膜原发性组织衰坏的原因探讨

PRIMARY TISSUE FAILURE OF BIOPROSTHETIG HEART VALVES

1977年12月至1990年6月用生物瓣作瓣膜替换术后生存434例(517个瓣膜)。经6～150(平均71.8±34.0)月随访,共2596.6病人年,121个生物瓣发生原发性组织衰坏,发生率为4.4%病人年,5年、10年无原发性组织衰坏率分别为90.1%和54.1%。经统计分析了生物瓣衰坏的高危因素,发现生物瓣较适用于老年组、三尖瓣和抗凝禁忌者;选用保存时间在1年以内的生物瓣,应用弹性支架和纯化戊二醛、改进设计和缝制可延长生物瓣的使用寿命。

From December,1977 to June,1990,434 patients survived from 517 bioprosth(?)ticvalve replacements.During 6 to 150 months(mean 70.7)followup(2596.6 patientyears),121 valves developed primary tissue failure(PTF).The incidence of PTF was4.4% pt-yr.Freedom rate of PTF was 90.1% at 5 years and 54.1% at 10 years.Highrisk factors of PTF was studied with Logistic stepwise multivariate regression analysis.We suggest that bioprosthetic heart valves are preferable for elder age,tricusipd valve replacement and patients with anticoagulation contraindication.The life of bioprostheticheart valves may be prolonged by using valves preserved within one year,flexible stent,purified glutaraldehyde and modifying design and manufacture.