フリースタイルのステントレスバイオプロテシスによる大動脈弁置換: 5年間の経験
K L Yun1, C F Sintek, A D Fletcher
1Department of Cardiac Surgery, Kaiser Permanente Medical Center, Los Angeles, CA 90027, USA. Kwok.L.Yun@KP.org
Circulation
|November 24, 1999
まとめ
フリースタイルのステントレス大動脈弁は,高齢の患者で5年間の優れた臨床結果と血液動力学的パフォーマンスを提供します. この弁置換手術は,良好な生存率と左心室縮症の有意な減少を示しています.
科学分野:
- 心血管外科手術についてです.
- 医学における生体材料
- 医療機器技術 医療機器技術について
背景:
- ステントのない大動脈弁は,生理学的流れとトランスバルブラー・グラデーションの減少を目的としています.
- 潜在的な利点には,手術後の左心房機能の改善と再構築が含まれます.
- フリースタイルバルブ (Medtronic, Inc) は,臨床的および血液動力学的アウトカムについて評価されました.
研究 の 目的:
- フリースタイル無ステント大動脈弁の5年間の臨床結果を将来的に分析するために.
- シリアルエコーカルディオグラフィーを用いてフリースタイルバルブの血液動力学的性能を評価する.
主な方法:
- フリースタイル義肢で大動脈弁置換を施した95人の高齢患者 (平均年齢75歳) の前向きな研究.
- エコーカルディオグラフィは,手術前,出院時に,および5年までの定期的な間隔で実施されました.
- 死亡率,再手術率,弁関連疾患率を含む臨床結果の分析.
主要な成果:
- 3%の30日間の手術死亡率と80%の5年間の精算的生存率.
- 5年後には94%の心臓死亡率と79%のバルブ関連疾患/死亡率から自由である.
- トランスバルブラー・グラデントと左心室質量指数の大幅な減少,効果的穴面積の増加.
結論:
- フリースタイルのステントレスバルブは,高齢者に安全に埋め込まれています.
- 優秀な中期臨床および血液動力学的結果が観察されました.
- 優れた血液動力学には,グラデーションの減少,穴の面積の改善,左心室縮の回帰が含まれています.
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