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首页> 外文期刊>Journal of cardiac surgery. >Early structural valve deterioration and reoperation associated with the mitroflow aortic valve
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Early structural valve deterioration and reoperation associated with the mitroflow aortic valve

机译：与MITROFLOW主动脉瓣相关的早期结构阀劣化和再生

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Background Structural valve deterioration (SVD) is a known limitation of bioprosthetic valves. Recent reports have suggested a concerning rate of early SVD in patients receiving a Mitroflow aortic bioprosthesis. We therefore compared the incidence of SVD and SVD requiring reoperation among patients receiving a Mitroflow versus a common contemporary bioprosthesis. Methods A retrospective cohort analysis was performed on 592 patients receiving a Mitroflow aortic bioprosthesis at our institution between 2010 and 2014. Patients were matched 1:1 using a coarsened exact matching algorithm with patients receiving a Carpentier-Edwards Magna Ease aortic bioprosthesis (Edwards Lifesciences, Irvine, CA) during the same period. The incidence of SVD (defined as a mean transprosthetic gradient = 30 mmHg or moderate to severe intraprosthetic regurgitation), reoperation for SVD, and cumulative survival were compared between prosthesis types. Results The cumulative incidence of SVD at 5 years for all patients receiving a Mitroflow aortic bioprosthesis was 16% (13-21%) and 5% underwent reoperation for SVD. Implantation of a Mitroflow valve was associated with an increased risk of SVD compared to the comparator valve (hazard ratio [HR] 2.59 [1.69-3.98], P 0.01). Older age had a protective effect against SVD (HR 0.95 [0.93-0.96], P 0.01). Patients who received a Mitroflow valve had reduced long-term survival compared to those who received a comparator valve (P = 0.03). Conclusion The Mitroflow aortic bioprosthesis is associated with increased rates of early SVD and reoperation for valvular dysfunction as well as reduced survival compared to a contemporary valve. Enhanced clinical and echocardiographic follow-up is advisable after Mitroflow implantation.
机译：背景技术结构阀劣化（SVD）是生物假体阀的已知限制。最近的报道提出了接受米特洛主动脉生物化学患者的早期SVD的率。因此，我们比较了SVD和SVD的发生率，需要重新开始，接受米特洛与常见的当代生物制剂相比。方法对2010年至2010年期间的592名患者进行了回顾性队列分析，在2010年至2010年间接受了我们的机构的米特洛主动脉素生物假期。患者使用粗糙的精确匹配算法与接受Carpentier-Edwards Magna的患者进行粗糙的精确匹配算法（Edwards Lifesciences， Irvine，CA）在同一时期。 SVD的发病率（定义为平均颞抑制梯度＆ = 30mmHg或中度至严重的内部内腹腔刺激反流性），在假体类型之间比较了SVD的重新组合和累积存活。结果所有接受米特洛主动脉生物假体的患者的SVD累积发生率为16％（13-21％）和5％的SVD再次再生。与比较器阀（危险比[HR] 2.59 [1.69-3.98]，P <0.01）相比，植入摩特洛阀的植入与SVD的风险增加有关。年龄较大的年龄对SVD具有保护作用（HR 0.95 [0.93-0.96]，P <0.01）。接收米特洛阀的患者与接收比较器阀的人相比，长期存活率降低了（P = 0.03）。结论米特洛主动脉瘤与瓣膜功能障碍的早期SVD和重新进食的增加相关，以及与当代阀相比减少存活率。在MITROFLOW植入后，建议增强临床和超声心动图随访。

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