ミトラおよび大動脈のスター・エドワーズ義肢における全身性血栓塞栓症: 10年から19年の追跡調査
Circulation
|August 1, 1982
まとめ
システミック栓塞は,特に以前のモデルでは,スター・エドワーズ義肢を持つ患者にとって重要なリスクであり続けています. 長期フォローアップでは,生存と神経機能に影響を与える持続的な血栓塞栓性イベントが示されています.
科学分野:
- 心血管外科手術についてです.
- バイオマテリアル科学 バイオマテリアル科学
- 臨床流行病学 臨床流行病学とは
背景:
- スター・エドワードの義肢は,ミトラ弁と大動脈弁の置換に広く使用されました.
- 血栓栓塞栓症に関する長期的な結果は,患者の管理において極めて重要です.
研究 の 目的:
- mitra valve replacement (MVR) と aortic valve replacement (AVR) のスタール・エドワード義肢を受診している患者における全身性血栓塞栓症の長期的な発生率とアウトカムを評価する.
主な方法:
- 1962年から1971年の間にMVRまたはAVRを受けた302人の患者を遡及的に調査した.
- 追跡期間は10年から19年であった.
- 脳栓塞,神経学的欠陥,および死亡率を含む,血栓塞栓的イベントの分析.
主要な成果:
- 系統性血栓塞栓症からの長期的な自由度は,10年後に66%,15年後に58%であった.
- 最近のバルブモデルは,以前のモデルと比較して10年自由率 (70% MVR, 74% AVR) が高かった.
- 脳栓塞は最も一般的であり,神経学的欠陥と死亡の有意な割合がありました.
- 不十分な抗凝固薬と,以前のミトラ骨義肢モデル (モデル6000) は,より高い血栓の発生率と関連していました.
結論:
- システミック栓塞は,スター・エドワーズ弁置換術後の持続的で重大な合併症です.
- 抗凝固剤の管理と義肢のモデルは,血栓栓塞栓のリスクに影響を与える重要な要因です.
- これらの発見は,慎重に患者の選択とモニタリングの必要性を強調しています.
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