Long Term Results of Carbomedics Mechanical Valve

Carbomedics 기계판막 치환환자의 장기성적

  • Published : 2000.07.01

Abstract

Background; The aim of this study is to evaluate our clinical experience with the Carbomedics heart valve prosthesis. Material and Method; Between Aug. 1988 and Dec. 1998, 294 Carbomidics valves were implanted in 235 patients(mitral; 143, mitral and aortic; 59, aortic; 33) The mean age at operation is 40.0$\pm$12.3 years(range 7 to 68 years); 63.8% (150patients) were woman. Follow up was 97.4% complete and mean follow up time was 5.7years with a total of 1209.2 patient-years. Result; The hospital mortality was 8.9%(mitral; was 95.2$\pm$1.6%(mitral ; 94.9$\pm$2.1%, mitral and aortic 95.0$\pm$3.7%, aortic 96.2$\pm$3.8%). Actual freedom rates from complications(linearized rates in parentheses) were fllowings; thromboembolism 96.2$\pm$1.5%(0.59%pt-yr), valve thrombosis 96.7$\pm$1.4%(0.5%/pt/yr), anticoagulant related hemorrhage 98.3$\pm$1.0%(0.25%/pt-yr), perivalvular leak 99.0$\pm$1.4%(0.5%/pt-yr), endocarditis 98.7$\pm$1.0%(0.25%/pt-yr), perivalvular leak 99.0$\pm$0.7%(0.17%pt-yr), endocarditis 98.7$\pm$1.0%(0.17%$\pm$pt-yr) and overall valve-related complications 88.9$\pm$2.5%(1.68%/pt-yr). Conclusion; The clinical performance of the Carbomedics valve was quite satisfactory with a low incidence of valve related mortality and morbidity.

배경; Carbomedics 기계판막은 보편적으로 많이 이용되는 기계판막의 일종이며 국립의료원에서는 1988년부터 이것을 사용하여 왔다. 저자들은 1994년에 중단기 성적을 흉부외과 학회지에 보고한바 있으며 이번에 10년 임상성적을 보고하고자 한다. 대상 및 방법 ; 1988년 8월부터 1998년 12월 RK지 Crbomedics 판막을 이용하여 판막치환술을 받은 235명의 연속적인 환자를 대상으로 하였으며 승모판막 치환 143예, 승모판막 및 대동맥판막치환 59예, 대동맥 판막치환 33예이었다. 평균 연령은 40세 이었으며 남녀의 성비는 85;150으로 여성환자가 원등하게 많았다. 임상추적 종료시점은 1999년 6월로 정했으며 추적율은 9704% 이었다. 전체 추적 기간은 1209.2환자-년이었고 평균 5.7년이었다. 결과; 조기 사망류은 8.9%, 만기 사망률은 4.7%로 전체사망율은 13.1%(31명/235명)이었다. 10년 생존율은 95.2$\pm$1.6%이었다. (승모판막치환; 94.9$\pm$2.1%, 승모판막 및 대동맥판막치환; 95.0$\pm$3.7%, 대동맥판막치환; 96.2$\pm$3.8%). 판막관련 합병증 중 혈전전색증, 판막혈전폐쇄증, 항응고제 관련 출혈, 판막주위 누출, 심내막염등의 linearized incidencesns 각각 환자-년당 0.59%, 0.5%, 0.25%, 0.17%, 0.17%였으며 혈전전색증이 없을 확률은 96.2$\pm$1.5%, 판막폐쇄증이 없을 확률은 96.7$\pm$1.4%, 항응고제관련 출혈이 없을 확률은 98.7$\pm$1.0%이었고 전체 판막관련 합병증이 없을 확률은 88.9$\pm$2.5%이었다. 결론; 장기 추적검사에서 Carbomedics 판막은 판막과 관련된 합병증 및 사망률이 낮았다.

Keywords

References

  1. J Cardiovasc Surg v.31 Clinical and functional evaluation of the carbomedics prosthetic heart valve in the mitral position Subotic S;Petrovin P;Boskovic D(et al.)
  2. JACC v.21 Echocardiographic Description of the Carbomedics bileaflet prosthetic heart valve Chambers J;Cross J;Deverall P;Sowton E
  3. Eur J Cardio-thorac Surg v.6 Carbomedics and St Jude Medical bileaflet valves: an in vitro and in vivo comparison Johnston RT;Weerasena NA;Butterfield M;Fisher J;Spypt TJ
  4. Ann Thorac Surg v.52 Comparative study of the hydrodynamic function of the Carbomedics valve Butterfield M;Fisher J;Davies GA;Spypt TJ
  5. Br Heart J v.67 Closing sounds and related complaints after heart valve replacement with St-Jude medical, Duromedics Edwards, Bjork-shiley Monostrut, and Cardiomedics prostheses Moritz A;Steinseifer U;Kobinia A(et al.)
  6. 대흉외지 v.27 Carbomedics 기계 판막의 임상적연구 김병열;문준호;강경훈;이정호;유회성
  7. J Thorac Cardiovasc Surg Guidelines for reporting morbidity and mortality after cardiac vlvular operations Edmunds LHJr;Clark RE;Cohn LH;Miller DC;Weisel RD
  8. The Clinical Report v.11 no.1
  9. Ann Thorac Surg v.66 Up to Eight years' follow up of 997 patients Receving the Cardiomedics Prosthetic Heart Valve Fiane AE;Gerian DR;Svennevig JL
  10. Ann Thorac Surg v.65 The Carbomedics Valve; Experience with 1049 implants Bernal JM;Rabasa JM;Garcia FG;Morales C;Nistal JF;Revuelta JM
  11. J Heart Valve Dis v.4 Seven and a half years clinical experience with the Carbomedics prosthetic heart valve Aagaard J;Hansen CN;Tingleff J;Rygg I
  12. J Thorac Cardiovasc Surg v.108 Long term results of valve replacement with the St. Jude Medical Valve Aoyagi S;Oryoji A;Nishi Y;Tanaka K;Kosuga K;Oishi K
  13. J Thorac Cardiovasc Surg v.100 Ten year experience with the St-Jude Medical valve for primary valve replacement Czer LSC;Chaux A;Matloff JM(et al.)
  14. Ann Thorac Surg Eight year's experience with the Medtronic Hall Valve prosthesis Vallejo JL;Gonzalez-Santos JM;Albertos J(et al.)
  15. 대흉외지 v.31 St. Jude Medical 판막에 의한 승모판 치환술의 임상성적 장원채;신성현;나국주;김상형
  16. Ann Thorac Surg v.47 Ten years' experience with the St-Jude Medical valve prosthesis Arom KV;Nicoloff DM;Kersten TE;Northrup WF;Lindsay WG;Emery RW
  17. J Thorac Cardiovasc Surg v.108 The St-Jude Medical Valve. Experience with 1000cases Khan S;Chaux A;Matloff J(et al.)
  18. Ann Thorac Surg v.58 Four year experience withthe Carbomedics valve: The North American Experience Copeland III JG;Sethi GK(et al.)
  19. J Thorac Cardiovasc Surg v.106 Midterm follow up after heart valve replacement with Carbomedics bileaflet prosthesis De Lu ca L;Vitale N;Giannolo B;Caferella G;Piazza L;Cotrufo M
  20. Ann Thorac Surg v.63 Five-year follow up after heart valve replacement with the Carbomedics bileaflet prosthesis Rodler SM;Moritz A;Schreiner W;End A;Dubsky P;Wolner E