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首页> 外文期刊>Journal of cardiac surgery. >Acute mechanical valve thrombosis of the St. Jude medical prosthesis.
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Acute mechanical valve thrombosis of the St. Jude medical prosthesis.

机译：圣裘德医疗假肢的急性机械瓣膜血栓形成。

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From 1986 to 1996, 2585 patients underwent valve replacement with the St. Jude medical prosthesis. Sixty experienced mechanical valve thrombosis. Seventeen of 60 patients (28.3%) had isolated aortic valve replacements, 33 had isolated mitral valve replacements (55%), and 10 had double valve replacements (16.7%) (aortic and mitral valve replacement). All patients who underwent reoperation for mechanical valve thrombosis were functional Class III or IV. Against medical advice, systemic anticoagulation with warfarin sodium had been discontinued or used only intermittently. Thus, anticoagulant activity was not adequate. The diagnosis of thrombosis was made by clinical examination, laboratory findings, and echocardiography and cineradiography. Of the 60 patients, 9 patients died early after surgery or before discharge. Most of the deaths were attributed to low cardiac output. The overall hospital mortality was 15%. The overall 10-year actuarial survival rate was 82.8+/-1.6%. In our study, reoperation for thrombosed mechanical prosthesis was not an independent parameter determining mortality. Age was the only statistically important hospital mortality predictor. Of this group, 90% suffered mechanical valve obstruction within the first 5 years after operation. These results suggest that valve re-replacement appears to be a suitable surgical treatment for thrombosis of mechanical prosthetic valves, especially in the young. In these patients subsequent anticoagulation management is necessary.
机译：从1986年到1996年，有2585例患者接受了St. Jude医用假体的瓣膜置换术。六十例机械瓣膜血栓形成。 60例患者中有17例（28.3％）进行了主动脉瓣置换，33例进行了二尖瓣置换（55％），10例进行了双瓣置换（16.7％）（主动脉和二尖瓣置换）。所有因机械瓣膜血栓形成而再次手术的患者均属于功能性III级或IV级。根据医学建议，已停用华法林钠进行全身性抗凝或仅间断使用。因此，抗凝活性不足。血栓形成的诊断是通过临床检查，实验室检查以及超声心动图和放射线照相来进行的。在这60例患者中，有9例在手术后或出院前死亡。大多数死亡归因于心输出量低。整体医院死亡率为15％。 10年总精算生存率为82.8 +/- 1.6％。在我们的研究中，血栓性机械假体的再手术不是决定死亡率的独立参数。年龄是唯一具有统计学意义的重要医院死亡率预测指标。在这一组中，有90％在手术后的前5年内遭受了机械瓣膜阻塞。这些结果表明，瓣膜置换似乎是机械性人工瓣膜血栓形成的一种合适的外科治疗方法，尤其是在年轻人中。在这些患者中，随后的抗凝治疗是必要的。

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