Carpentier-Edwards 牛心嚢膜弁を用いた高齢者大動脈弁置換術の遠隔成績の検討 フランス・Trousseau 病院での経験
1984年から1995年12月にかけて, Carpentier-Edwards 牛心嚢膜弁を用いて大動脈弁置換術を施行した60歳以上の652例について遠隔成績を検討した. 平均年齢は72.2±6.7歳で, 約7割が男性であった. 1996年の7月からの3カ月の調査期間において, 1例を除き全症例の追跡が可能で, 平均観察期間4.4年, 累積観察期間2,802患者・年であった. 遠隔期死亡は138例で, そのうち弁関連死亡は30例であった. 弁関連合併症としては, 塞栓症37例, 感染弁14例, 出血10例, 再手術8例, 人工弁機能不全2例であった. 術後12年の人工弁機能不全非発生率は98±...
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| Published in | 日本心臓血管外科学会雑誌 Vol. 29; no. 6; pp. 373 - 377 |
|---|---|
| Main Author | |
| Format | Journal Article |
| Language | Japanese |
| Published |
特定非営利活動法人 日本心臓血管外科学会
2000
|
| Subjects | |
| Online Access | Get full text |
| ISSN | 0285-1474 1883-4108 |
| DOI | 10.4326/jjcvs.29.373 |
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| Abstract | 1984年から1995年12月にかけて, Carpentier-Edwards 牛心嚢膜弁を用いて大動脈弁置換術を施行した60歳以上の652例について遠隔成績を検討した. 平均年齢は72.2±6.7歳で, 約7割が男性であった. 1996年の7月からの3カ月の調査期間において, 1例を除き全症例の追跡が可能で, 平均観察期間4.4年, 累積観察期間2,802患者・年であった. 遠隔期死亡は138例で, そのうち弁関連死亡は30例であった. 弁関連合併症としては, 塞栓症37例, 感染弁14例, 出血10例, 再手術8例, 人工弁機能不全2例であった. 術後12年の人工弁機能不全非発生率は98±2%, 再手術の回避率は96±4%, 弁関連合併症の非発生率は58±25%, 弁関連死亡非発生率は76±24%であった. 牛心嚢膜弁は術後遠隔期の弁関連合併症, とくに人工弁機能不全の発生は少なく, 60歳以上の高齢者に対する大動脈弁置換術においては優れた選択枝と考えられる. |
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| AbstractList | 1984年から1995年12月にかけて, Carpentier-Edwards 牛心嚢膜弁を用いて大動脈弁置換術を施行した60歳以上の652例について遠隔成績を検討した. 平均年齢は72.2±6.7歳で, 約7割が男性であった. 1996年の7月からの3カ月の調査期間において, 1例を除き全症例の追跡が可能で, 平均観察期間4.4年, 累積観察期間2,802患者・年であった. 遠隔期死亡は138例で, そのうち弁関連死亡は30例であった. 弁関連合併症としては, 塞栓症37例, 感染弁14例, 出血10例, 再手術8例, 人工弁機能不全2例であった. 術後12年の人工弁機能不全非発生率は98±2%, 再手術の回避率は96±4%, 弁関連合併症の非発生率は58±25%, 弁関連死亡非発生率は76±24%であった. 牛心嚢膜弁は術後遠隔期の弁関連合併症, とくに人工弁機能不全の発生は少なく, 60歳以上の高齢者に対する大動脈弁置換術においては優れた選択枝と考えられる. |
| Author | 中島, 博之 |
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| References | 20) Jamieson, W. R. E., Miyagishima, R. T., Grunkemeier, G. L. et al.: Bileaflet mechanical prostheses for aortic valve replacement in patients younger than 65 years and 65 years of age or older: Major thromboembolic and hemorrhagic complications. Can. J. Surg. 42: 27-36, 1999. 2) Hammermeister, K. E., Sethi, G. K., Henderson, W. G. et al.: A comparison of outcomes in men 11 years after heart-valve replacement with a mechanical valve or bioprosthesis. N. Engl. J. Med. 328: 1289-1296, 1993. 12) Burdon, T. A., Miller, D. C., Oyer, P. E. et al.: Durability of porcine valves at fifteen years in a representative North American patient population. J. Thorac. Cardiovasc. Surg. 103: 238-252, 1992. 13) Jamieson, W. R. E., Munro, A. I., Miyagishima, R.T. et al.: Carpentier-Edwards standard porcine bioprosthesis: Clinical performance to seventeen years. Ann. Thorac. Surg. 60: 999-1007, 1995. 19) Bernal, J. M., Rabasa, J. M., Gutierrez-Garcia, F. et al.: The CarboMedics valve: Experience with 1049 implants. Ann. Thorac. Surg. 65: 137-143, 1998. 18) Craver, J.: CarboMedics prosthetic heart valve. Eur. J. Cardiothorac. Surg. 15 (suppl. 1): S3-S11, 1999. 7) Walley, V. M. and Keon, W. J.: Patterns of failure in Ionescu-Shiley bovine pericardial bioprosthetic valves. J. Thorac. Cardiovasc. Surg. 93: 925-933, 1987. 1) Edmunds, L. H., Jr., Clark, R. E., Cohn, L. H. et al.: Guidelines for reporting morbidity and mortality after cardiac valvular operations. Ann. Thorac. Surg. 62: 932-935, 1996. 4) Becker, R. M., Strom, J., Frishman, W. et al.: Hemodynamic performance of the Ionescu-Shiley valve prosthesis. J. Thorac. Cardiovasc. Surg. 80: 613-620, 1980. 6) Leandri, J., Bertrand, P., Mazzucotelli, J. P. H. et al.: Mode of failure of the Mitroflow pericardial valve. J. Heart Valve. Dis. 1: 225-231, 1992. 17) Burckhardt, D., Striebel, D., Vogt, S. et al.: Heart valve replacement with St. Jude Medical valve prosthesis. Circulation 78 (suppl. I): I-18-I-24, 1988. 5) Teoh, K. H., Ivanov, J., Weisel, R. D. et al.: Survival and bioprosthetic valve failure. Circulation 80 (suppl. I): I-8-I-15, 1989. 14) Frater, R. W. M., Furlong, P., Cosgrove, D. M. et al.: Long-term durability and patient functional status of the Carpentier-Edwards perimount pericardial bioprosthesis in the aortic position. J. Heart Valve. Dis. 7: 48-53, 1998. 8) Cosgrove, D. M., Lytle, B. W., Taylor, P. C. et al.: The Carpentier-Edwards pericardial aortic valve ten-year results. J. Thorac. Cardiovasc. Surg. 110: 651-662, 1995. 16) Czer, L. S. C., Chaux, A., Matloff, J. M. et al.: Ten-year experience with the St. Jude Medical valve for primary valve replacement. J. Thorac. Cardiovasc. Surg. 100: 44-55, 1990. 3) Holper, K., Wottke, M., Lewe, T. et al.: Bioprosthetic and mechanical valves in the elderly: Benefits and risks. Ann. Thorac. Surg. 60: S443-S446, 1995. 9) Pelletier, L. C., Carrier, M., Leclerc, Y. et al.: The Carpentier-Edwards pericardial bioprosthesis: Clinical experience with 600 patients. Ann. Thorac. Surg. 60: S297-302, 1995. 10) Aupart, M. R., Sirinelli, A. L., Diemont, F. F. et al.: The last generation of pericardial valve in the aortic position: Ten-year follow-up in 589 patients. Ann. Thorac. Surg. 61: 615-620, 1996. 11) Magilligan, D. J., Lewis, J. W., Stein, P. et al.: The porcine bioprosthetic heart valve: Experience at 15 years. Ann. Thorac. Surg. 48: 324-330, 1989. 15) 高原善治, 須藤義夫, 村山博和ほか: Carpentier-Edwards 牛心膜弁の長期遠隔成績の検討. 日胸外会誌43: 1097-1102, 1995. |
| References_xml | – reference: 20) Jamieson, W. R. E., Miyagishima, R. T., Grunkemeier, G. L. et al.: Bileaflet mechanical prostheses for aortic valve replacement in patients younger than 65 years and 65 years of age or older: Major thromboembolic and hemorrhagic complications. Can. J. Surg. 42: 27-36, 1999. – reference: 3) Holper, K., Wottke, M., Lewe, T. et al.: Bioprosthetic and mechanical valves in the elderly: Benefits and risks. Ann. Thorac. Surg. 60: S443-S446, 1995. – reference: 6) Leandri, J., Bertrand, P., Mazzucotelli, J. P. H. et al.: Mode of failure of the Mitroflow pericardial valve. J. Heart Valve. Dis. 1: 225-231, 1992. – reference: 8) Cosgrove, D. M., Lytle, B. W., Taylor, P. C. et al.: The Carpentier-Edwards pericardial aortic valve ten-year results. J. Thorac. Cardiovasc. Surg. 110: 651-662, 1995. – reference: 11) Magilligan, D. J., Lewis, J. W., Stein, P. et al.: The porcine bioprosthetic heart valve: Experience at 15 years. Ann. Thorac. Surg. 48: 324-330, 1989. – reference: 17) Burckhardt, D., Striebel, D., Vogt, S. et al.: Heart valve replacement with St. Jude Medical valve prosthesis. Circulation 78 (suppl. I): I-18-I-24, 1988. – reference: 19) Bernal, J. M., Rabasa, J. M., Gutierrez-Garcia, F. et al.: The CarboMedics valve: Experience with 1049 implants. Ann. Thorac. Surg. 65: 137-143, 1998. – reference: 5) Teoh, K. H., Ivanov, J., Weisel, R. D. et al.: Survival and bioprosthetic valve failure. Circulation 80 (suppl. I): I-8-I-15, 1989. – reference: 12) Burdon, T. A., Miller, D. C., Oyer, P. E. et al.: Durability of porcine valves at fifteen years in a representative North American patient population. J. Thorac. Cardiovasc. Surg. 103: 238-252, 1992. – reference: 2) Hammermeister, K. E., Sethi, G. K., Henderson, W. G. et al.: A comparison of outcomes in men 11 years after heart-valve replacement with a mechanical valve or bioprosthesis. N. Engl. J. Med. 328: 1289-1296, 1993. – reference: 7) Walley, V. M. and Keon, W. J.: Patterns of failure in Ionescu-Shiley bovine pericardial bioprosthetic valves. J. Thorac. Cardiovasc. Surg. 93: 925-933, 1987. – reference: 13) Jamieson, W. R. E., Munro, A. I., Miyagishima, R.T. et al.: Carpentier-Edwards standard porcine bioprosthesis: Clinical performance to seventeen years. Ann. Thorac. Surg. 60: 999-1007, 1995. – reference: 16) Czer, L. S. C., Chaux, A., Matloff, J. M. et al.: Ten-year experience with the St. Jude Medical valve for primary valve replacement. J. Thorac. Cardiovasc. Surg. 100: 44-55, 1990. – reference: 9) Pelletier, L. C., Carrier, M., Leclerc, Y. et al.: The Carpentier-Edwards pericardial bioprosthesis: Clinical experience with 600 patients. Ann. Thorac. Surg. 60: S297-302, 1995. – reference: 15) 高原善治, 須藤義夫, 村山博和ほか: Carpentier-Edwards 牛心膜弁の長期遠隔成績の検討. 日胸外会誌43: 1097-1102, 1995. – reference: 18) Craver, J.: CarboMedics prosthetic heart valve. Eur. J. Cardiothorac. Surg. 15 (suppl. 1): S3-S11, 1999. – reference: 4) Becker, R. M., Strom, J., Frishman, W. et al.: Hemodynamic performance of the Ionescu-Shiley valve prosthesis. J. Thorac. Cardiovasc. Surg. 80: 613-620, 1980. – reference: 14) Frater, R. W. M., Furlong, P., Cosgrove, D. M. et al.: Long-term durability and patient functional status of the Carpentier-Edwards perimount pericardial bioprosthesis in the aortic position. J. Heart Valve. Dis. 7: 48-53, 1998. – reference: 1) Edmunds, L. H., Jr., Clark, R. E., Cohn, L. H. et al.: Guidelines for reporting morbidity and mortality after cardiac valvular operations. Ann. Thorac. Surg. 62: 932-935, 1996. – reference: 10) Aupart, M. R., Sirinelli, A. L., Diemont, F. F. et al.: The last generation of pericardial valve in the aortic position: Ten-year follow-up in 589 patients. Ann. Thorac. Surg. 61: 615-620, 1996. |
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| Snippet | 1984年から1995年12月にかけて, Carpentier-Edwards 牛心嚢膜弁を用いて大動脈弁置換術を施行した60歳以上の652例について遠隔成績を検討した. 平均年齢は72.2±6.7歳で, ... |
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| SubjectTerms | Carpentier-Edwards 牛心嚢膜弁 大動脈弁置換術 構造的劣化 遠隔成績 高齢者 |
| Subtitle | フランス・Trousseau 病院での経験 |
| Title | Carpentier-Edwards 牛心嚢膜弁を用いた高齢者大動脈弁置換術の遠隔成績の検討 |
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