老年患者主动脉瓣置换术后不匹配对患者远期生存影响的研究

研究老年患者主动脉瓣置换术（AVR）后生存情况,评估人工瓣膜-患者不匹配（PPM）对患者远期生存率的影响.回顾性分析了自2000年7月～2005年7月的100例65岁以上实施单纯性AVR或同时行冠状动脉旁路移植术患者的资料.临床随访时间定于术后1个月、6个月、1年、3年、5年、7年及以上,收集并分析主动脉瓣位平均跨瓣压差（MGP）、左室射血分数（LVEF）、实际生存率等数据,比较患者的远期生存情况.患者术后30天病死率两组间差异有统计学意义.长期生存率自第7年开始在两组间表现出显著差异,组内差异表现在重度不匹配组.老年患者AVR术后PPM与术后早期病死率密切相关,重度PPM似乎影响远期生存率.

Aortic Valve Prosthesis Mismatch on the Long-term Survival in Elderly Patients

To evaluate the effect of valve prosthesis-patient mismatch on the long-term survival of elderly patients after aortic valve replacement, 100 patients, age 65 years and older, who underwent simple aortic valve replacement or with concomitant coronary artery bypass grafting from July 2000 to July 2005 were retrospectively analyzed. They were followed up at the end of 1st month, 6th month, 1st year, 3rd year, 5th year and 7th year and longer post-operatively. Mean trans-prosthetic pressure gradient, ejection fraction of left ventricle, survival information were collected and analyzed. The survival rate at 30th day post-operative between the two groups showed statistical difference. Long-term survival after 7 years post-operatively revealed significant difference between the groups, especially those with severe mismatch group. Within 1 year and after 5 years post-operatively, the mean trans-prosthetic pressure gradient, ejection fraction of left ventricle revealed significant difference between groups, while intra-group difference was noticed in the severe mismatch group. Valve prosthesis-patient mismatch after aortic valve replacement in elderly patients was closely related to early post operative mortality, and severe mismatch seemed to affect their long-term survival.