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CardiaMed机械瓣膜:一项多中心临床试验的中期结果

CardiaMed mechanical valve: mid-term results of a multicenter clinical trial.

作者信息

Nazarov Vladimir M, Zheleznev Sergey I, Bogachev-Prokophiev Alexandr V, Afanasyev Alexandr V, Nemchenko Eugene V, Jeltovskiy Yuri V, Lavinyukov Sergey O

机构信息

Meshalkin State Research Institute of Circulatory Pathology, Novosibirsk, Russian Federation.

出版信息

Asian Cardiovasc Thorac Ann. 2014 Jan;22(1):9-17. doi: 10.1177/0218492312464035. Epub 2013 Jul 9.

Abstract

BACKGROUND

Prosthesis choice is a major concern in valvular surgery.

METHODS

A multicenter clinical trial was performed to assess the efficacy and safety of the CardiaMed prosthetic heart valve. The study enrolled 420 patients who underwent mitral (209) or aortic (211) valve replacement from 2003 to 2004 at 7 institutions in Russia, and who were followed up from 2006 to 2011. The mean age was 52.2 ± 10.2 years (range, 12-78 years), 47.4% were female, and 99.05% completed the study.

RESULTS

The maximum observation term was 7.5 years (2188.5 patient-years); 1081.6 patient-years for aortic and 1106.9 patient-years for mitral valve replacement. The overall 7-year survival rate was 85.1%  ± 3.7%; 86.1%  ± 4.8% and 84.4%  ± 5.4% for aortic and mitral valve replacement, respectively. The 7-year freedom from valve-related death was 93.9%  ± 3.7% and 94.5%  ± 3.2% for aortic and mitral valve replacement, respectively. When early mortality (<30 days) was excluded, these rates were 94.8%  ± 3.1% and 93.8%  ± 3.82%, respectively. Linearized valve-dependent complication rates were determined for structural valve failure (0%/patient-year overall), thrombosis (0.63%/patient-year, all for mitral valve replacement), thromboembolic complications including transient neurologic deficits (0.13%/patient-year overall, 0.5%/patient-year for aortic valve replacement, 0.8%/patient-year for mitral valve replacement), hemorrhagic bleeding (0.64%/patient-year overall, 0.55%/patient-year for aortic valve replacement, 0.09%/patient-year for mitral valve replacement), prosthetic endocarditis (0.28%/patient-year overall, 0.28%/patient-year for aortic valve replacement, 0%/patient-year for mitral valve replacement), and hemolysis (0%/patient-year overall).

CONCLUSION

The CardiaMed mechanical heart valve prostheses meets world standards of safety and efficacy.

摘要

背景

人工瓣膜的选择是瓣膜手术中的一个主要问题。

方法

进行了一项多中心临床试验,以评估CardiaMed人工心脏瓣膜的有效性和安全性。该研究纳入了420例患者,他们于2003年至2004年在俄罗斯的7家机构接受了二尖瓣(209例)或主动脉瓣(211例)置换术,并于2006年至2011年进行了随访。平均年龄为52.2±10.2岁(范围12 - 78岁),47.4%为女性,99.05%完成了研究。

结果

最长观察期为7.5年(2188.5患者年);主动脉瓣置换为1081.6患者年,二尖瓣置换为1106.9患者年。总体7年生存率为85.1%±3.7%;主动脉瓣置换和二尖瓣置换分别为86.1%±4.8%和84.4%±5.4%。主动脉瓣置换和二尖瓣置换的7年瓣膜相关死亡自由率分别为93.9%±3.7%和94.5%±3.2%。排除早期死亡率(<30天)后,这些率分别为94.8%±3.1%和93.8%±3.82%。确定了线性化的瓣膜相关并发症发生率,包括结构性瓣膜故障(总体0%/患者年)、血栓形成(0.63%/患者年,均为二尖瓣置换)、血栓栓塞并发症包括短暂性神经功能缺损(总体0.13%/患者年,主动脉瓣置换为0.5%/患者年,二尖瓣置换为0.8%/患者年)、出血性出血(总体0.64%/患者年,主动脉瓣置换为0.55%/患者年,二尖瓣置换为0.09%/患者年)、人工瓣膜心内膜炎(总体0.28%/患者年,主动脉瓣置换为0.28%/患者年,二尖瓣置换为0%/患者年)和溶血(总体0%/患者年)。

结论

CardiaMed机械心脏瓣膜假体符合世界安全和有效性标准。

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