猪瓣膜替换二尖瓣患者瓣膜功能失调18例分析

本文报道应用猪瓣膜替换二尖瓣后长期生存150例,其中已有18例因发(?)猪瓣膜功能失调而再次施行瓣膜替换术。18例患者有心悸、气急、疲劳和胸痛等症状。主要的诊断依据是出现新的杂音,超声心动图和多普勒检查发现瓣膜破损和反流。瓣膜损害是瓣叶钙化和严重纤维组织增生,其中7例有慢性感染。再次替换18例损破的猪瓣膜,应用机械瓣12个,弹性支架猪瓣6个,手术存活13例,死亡5例。

CAUSES OF FAILURE IN 18 PORCINE BIOPROSTHETIC VALVES

From August 1978 to November 1989, glutaral dehyde preserved porcine bioprosthetic valve was used for mitral valve replacement. Among 150 pa tients with valvular replacement, 18 cases with palpitation, dyspnea, fatigue and thoracic pain needed reoperation because of valve failure. The diagnosis of valve failure was confirmed by auscul tation, echocardiography and Doppler.The main features of failed valves in 18 cases were calcification of cusps, associated with severe hyperplasia of fibrous tissue in 13 and chronic infection of porcine valves in 7. The disruption of leaflet was attributed to calcification and fibrous tissue hyperplasia.Reoperation for replacement of the dysfunc tioning valves resulted in 13 recoveries and 5 deaths.