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首页> 外文期刊>Journal of Thoracic Disease >Bovine pericardial versus porcine stented replacement mitral valves: early hemodynamic performance and clinical results of a randomized comparison of the Perimount and the Mosaic valves
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Bovine pericardial versus porcine stented replacement mitral valves: early hemodynamic performance and clinical results of a randomized comparison of the Perimount and the Mosaic valves

机译：牛心包与猪支架替代二尖瓣：早期血液动力学性能和临床结果的周边和马赛克阀门

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Background: To compare the hemodynamic and clinical outcomes following mitral valve replacement with the Perimount valve with those of the Mosaic valve. Methods: A total of 145 consecutive patients with rheumatic heart valve disease who underwent single bioprosthetic mitral valve replacement were randomized to receive either the Perimount (n=72) valve or the Mosaic bioprosthesis (n=73). The mean age of patients was 72.1 years (range, 58–89 years) with a sex distribution of 55.2% female and 44.8% male. Patients underwent follow up transthoracic echocardiography at 3 months and 1 year postoperatively. We compared demographics, preoperative clinical data, operative data, hemodynamic profiles, and clinical outcomes. Results: The cross-clamp time was similar, with 50.7±15.3 minutes for the Perimount and 50.7±21.8 minutes for the Mosaic bioprosthesis. The total bypass time was also similar, with 91.3±25.7 minutes for the Perimount and 87.8±25.6 minutes for the Mosaic valve. The peak and mean pressure gradients were lower in the Perimount group for all valve sizes and the difference was statistically significant at 1 year. The effective orifice area (EOA) was slightly larger in the Perimount valve (1.98±0.21 vs. 1.89±0.71 cm 2 , P=0.538) postoperatively, but there was no significant difference at 1 year. There were no differences in preoperative or postoperative left atrium diameter (LAD), left ventricular diastolic diameter (LVDD), left ventricular systolic diameter (LVSD), left ventricular ejection fraction (LVEF), pulmonary artery pressure (PAP). The mortality and major complications rate were similar between the two groups. Conclusions: The Perimount prostheses is superior to the Mosaic prostheses after mitral valve replacement, achieving statistically significant lower gradients and larger EOA when compared on the basis of manufacturer-labeled valve sizes. Both valves appear to provide satisfactory clinical results.
机译：背景：将二尖瓣瓣膜置换后的血流动力学和临床结果与镶嵌阀门的血流动力学和临床结果进行比较。方法：总共145例随机接受单一生物假体二尖瓣置换术后的风湿性心脏瓣膜病的患者，以接收周边（n = 72）瓣膜或马赛克生物假体（n = 73）。患者的平均年龄为72.1岁（范围，58-89岁），性分布55.2％，男性和44.8％。患者在术后3个月和1年后接受了Transthoracic超声心动图。我们比较了人口统计，术前临床数据，手术数据，血液动力学谱和临床结果。结果：交叉钳位时间相似，为周边50.7±15.3分钟，为马赛克生物假期50.7±21.8分钟。总旁路时间也相似，对于镶嵌阀门，91.3±25.7分钟，87.8±25.6分钟。峰值和平均压力梯度在所有阀门尺寸的周边组中较低，并且在1年内差异有统计学意义。术后，有效的孔口（EOA）略大于横幅瓣膜（1.98±0.21厘米，P = 0.538），但在1年内没有显着差异。术前或术后左心房直径（LAD），左心室舒张直径（LVDD），左心室收缩直径（LVSD），左心室喷射分数（LVEF），肺动脉压（PAP）中没有差异。两组之间的死亡率和主要并发症率相似。结论：在二尖瓣置换后，围场假体优于马赛克假体，在制造商标记的阀门尺寸的基础上，实现了统计上显着的较低梯度和更大的EOA。两个阀门似乎都提供了令人满意的临床结果。

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