牦牛心包瓣置换二尖瓣术后瓣膜毁损

１９８５至１９８７年用牦牛心包瓣置换二尖瓣。术后６５例随访至１９９３年９月，累积随访３７９．４病人年，平均６．９年。５年存活率７５％。晚期死亡９例，其中置换瓣膜心内膜炎（ＰＶＥ）５例，血栓栓塞（ＴＥ）、瓣膜毁损、心衰、原因不明各１例，死亡率３．６９％病人年。ＰＶＥ、ＴＥ发生率分别为１．３２％，０．２６％病人年。瓣膜毁损指：（１）瓣膜钙化、穿孔或撕裂，或（２）瓣膜中度以上狭窄或返流。瓣膜毁损可进一步分为轻度和重度。随访期间瓣膜毁损１６例，瓣膜毁损率４．２２％病人年。作者认为：牦牛心包瓣置换二尖瓣术后远期结果是可接受的，但术后５年开始应加强随访。为便于临床治疗及评价，生物瓣毁损可进一步分为轻度和重度。

Structural Valve Deterioration after Mitral Valve Replacement with Yak Pericardial Bioprostheses

From l986 to 1987, Yak pericardial Bioprostheses were inSerted as the mitral valve replacement substitute. After operation , 55 cases were followed to September 1993. The follow-up totalled 379. 4 patient-years,mean 6.9 years.5-year actural survial rate was 75%. There were 9 cases of deaths.The deaths were associated with PVE,TE,heart failure and structural valve deterioration except one. The late mortality rate was 3.69% patient years. PVE, and TE were 1.32%, 0.26% patient-years respectively.Structural valve deterioration is defined as: (1)bioprosthetic valve calclfication , perforation, or disruption; Dr(2) moderate or severe bioprosthetic valve stenosis or regurgitation, The deterioration Was further divided into the mild and the severe, There were 16 cases of structutal valve deterioration.The structural valve deterioration rate was 4.22% patient-years,It is believed that the long-term results of the mitral valve replacement with Yak Pericardial Bioprtatheses are acceptable. Because of incReasing cases of structural valved eterioration. there patients should be followed up carefully from the fifth year after operation. In order to treat and evaluate the patients, the structural valve deterioration of bioprostheses should be further divided into the mild and the severe.