Bivalvular mechanical mitral-aortic valve replacement in 254 patients: Long-term results - A 22-year follow-up

被引:17
作者
Remadi, JP
Baron, O
Tribouilloy, C
Roussel, JC
Al Habasch, O
Despins, P
Michaud, JL
Duveau, D
机构
[1] G&R Laennec Univ Hosp, Nantes, France
[2] Dept Cardiol, Amiens, France
关键词
D O I
10.1016/S0003-4975(03)00674-X
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background. We have retrospectively studied 254 patients who underwent a bivalvular mechanical mitralaortic replacement in the cardiovascular and thoracic surgery unit of Nantes from 1979 to 1989. The follow-up was 22 years (1979 to 2001). The last patient was operated on 12 years before the end of the follow-up. Methods. All mitral prostheses were St. Jude Medical (SJM) bileaflet valves, and the aortic prostheses were 124 monodisc Bjork-Shiley valves, 3 Sorin prostheses, and 127 St. Jude Medical bileaflet prostheses. The mean age was 56.8 +/- 8.5 years with a sex ratio equal to 1. Rheumatism as the etiology predominated with 79.5%. Ninety-seven percent of the patients were followed for a total of 2,779 patient-years and a mean of 11.7 years. Results. Operative mortality was 7.08%. Freedom from overall mortality and valve-related mortality at 22 years were 45.7% +/- 3.6% and 73.1% +/- 3%, respectively. The linearized rates of thromboembolic and hemorrhagic events were 1.07% and 0.9% per patient-year, respectively. Multivariate analysis showed age (p < 0.002), sex (p < 0.01), and degenerative etiology (p = 0.04) as independent factors of late mortality, and age, sex, degenerative disease, and tricuspid pathology were related to valve-related mortality. Conclusions. This study shows good results after mechanical mitral-aortic replacement in terms of survival rate and quality of life in surviving patients, and outlines the factors influencing long-term results as compared with isolated mitral valve replacement. (C) 2003 by The Society of Thoracic Surgeons.
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页码:487 / 492
页数:6
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