Long-term Management of Patients with Cardiac Valve Prostheses
スポンサーリンク
概要
- 論文の詳細を見る
Marked improvements have been achieved in the results of valve replacement due to recent developments in cardiac valve prostheses, surgical procedures, myocardial protection methods, and supportive techniques. Since 1974, the aortic valve has been replaced with mechanical valves and the mitral valve with biological valves at our institution. During a cumulative follow-up of 1024 patient-years after 306 valve replacements (126 AVR, 148 MVR and 32 AVR + MVR), the 10-year survival rates were 88% for AVR, 72.6% for MVR and 77.5% for AVR+MVR. The cardiac function of 90% of the survivors was evaluated as Class I or II according to NYHA Functional Classification. As for valve-related postoperative complications, thromboembolism was observed in 2.3%/pt-yr, hemorrhage in 5%/pt-yr, prosthetic valve endocarditis in 1.3%/pt-yr, perivalvular regurgitation in 1.3%/pt-yr and valve malfunction in 1.1%/pt-yr. Of the causes of late deaths, 62.5% were related to valve complications. Re-replacement of the prosthesis was necessary in 17 patients due to valve-related complications, and early death occurred in 1 (5.9%) of these 17. While cardiac valve replacement contributes to improvements in the quality of the patients' long-term postoperative life, currently employed artificial valves are still not ideal with regard to their materials and design, and re-replacement may become necessary in the late postoperative period. Therefore, in addition to selection of the appropriate valve prosthesis for different disorders and optimal prevention of valve-related complications, early diagnosis by non-invasive techniques and early treatment of these complications if they have occurred are of particular importance for the long-term management of patients following cardiac valve replacement.
- 社団法人日本循環器学会の論文
- 1986-09-20
著者
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Sasaki Takashi
Department of Cardiothoracic Surgery, Nippon Medical School
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Yamada Osamu
Department Of Pediatric Cardiology Division Of Cardiology National Cardiovascular Center
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Kozu Taeko
浜松医科大学 病理学第1
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Yamada Osamu
Department Of Cardiovascular Dynamics National Cardiovascular Center Research Institute
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Komatsu Sakuzo
The Department Of Surgery (section 2) Sapporo Medical University And Hospital
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Komatsu Sakuzo
Dept. Of Cardio-thoracic Surgery Sapporo Medical College And Hospital
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Komatsu Sakuzo
Department Of Surgery Section 2 Sapporo Medical College & Hospital
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Komatsu Sakuzo
Second Department Of Surgery Sapporo Medical College
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Sasaki Takashi
Department Of Bioregulation. Institute For Medical Genetics Kumamoto University Medical School
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Komatsu Sakuzo
Department Of Thoracic And Cardiovascular Surgery Sapporo Medical College And Hospital
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KAZUI Teruhisa
Department of Thoracic and Cardiovascular, Surgery, The Sapporo Medical University Hospital
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Kazui Teruhisa
The First Department Of Surgery Hamamatsu University School Of Medicine
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Komatsu Sakuzo
Department Of Thorac.& Cardiovas.surgery Sapporo Medical College
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Komatsu Sakuzo
Department Of Surgery (section 2) Sapporo Medical College And Hospital
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Kazui Teruhisa
Department Of Thoracic And Cardiovascular Surgery Sapporo Medical College And Hospital
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Kazui Teruhisa
Department Of Cardiovascular Surgery Cardiovascular Center Hokkaido Ohno Hospital
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Kazui T
Department Of Cardiovascular Surgery Cardiovascular Center Hokkaido Ohno Hospital
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Yamada Osamu
Department Of Thoracic And Cardiovascular Surgery Sapporo Medical College And Hospital
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Sasaki Takashi
Department Of Thoracic And Cardiovascular Surgery Sapporo Medical College And Hospital
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Sasaki Takashi
Department Of Applied Biological Chemistry Graduate School Of Agricultural And Life Sciences The Uni
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Komatsu Sakuzou
Department Of Thoracic And Cardiovascular Surgery Sapporo Medical College
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