人工弁置換術後遠隔期の合併症に関する臨床的研究 : 血栓・塞栓症及び溶血を中心として
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概要
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Prosthetic valve replacement has been widely performed and found effective for patients with severe valvular disease, although there are a few complications such as thrombus formation, embolization and hemolysis due to the side effect of the mechanical valve. This study is aids in grasping the real condition of these complications in patients with prosthetic valve replacement and in establishing the prevention or prophylactic consideration of it's complications. The follow up study was performed from the 6th to the 13th year after prosthetic valve replacement in 78 patients (mitral valve replacement MVR 54, aortic valve replacement AVR 13, multiple valve replacement 11). The results of this study are as follow : 1) The incidence of thromboembolism was observed in 34.6% of these patients, as a complication after valve replacement. Such a complication was mostly recognized in patients with MVR in the long-term period after surgery. 2) The selection of prosthetic heart valve was a very important factor to prevent thrombus formation. 3) It was clearly found that aggregation activity of platelet decreased remarkably by administration of dipyridamole in addition to Warfarin in anticoagulation therapy and incidence of thromboembolism decreased significantly as a result of observation of these patients. 4) Hemolysis was seen in all cases after surgery. There were no severe anemia clinically, unless destruction or dyrfunction of the implanted prosthetic heart valve occurred. Mild anemia could be restored by body rest.
- 神戸大学の論文