[原著］三尖弁置換術における機械弁(SJM弁)と生体弁(CE弁)の比較検討 : 置換時期と早期および遠隔成績

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Indications for tricuspid valve replacement (TVR) and the optimal prosthesis to use are still controversial. We examined the timing of TVR and the usefulness of St. Jude Medical (SJM) and Carpentier-Edwards (CE) valves retrospectively. The cases of 39 consecutive patients who underwent TVR at our hospital between 1976 and 1998 were reviewed. The patients were divided into initial operative group, comprising those who had TVR at the initial operation, and reoperative group, comprising those who had TVR at reoperation. Their ages, genders, diagnoses, used valves and necessity for re-TVR were analyzed for significant factors affecting prognosis. We also compared their ages, preoperative pulmonary capillary wedge pressures, pre- and postoperative right atrial pressures, preoperative cardiac indexes and survival rates of patients who had TVR with SJM valves with those who had TVR with CE valves. Although patients in the initial operative group were older than those in the reoperative group, there were no significant differences between the two groups in all factors. In comparing the patients with SJM valves versus those with CE valves, the CE patients were significantly older than the SJM patients (P=0.014), but no significant differences in the other factors were observed. Hospital mortality for all patients was 14.6% and late mortality was 17.1%. Actuarial survival rates at 5 and 10 years in all patients were 85.1% and 81.8%, respectively. The 5- and 10-year survival rates were 90.5% and 85.7%, respectively, in the patients undergoing TVR with SJM, whereas the rates in those who had TVR with CE were 81.8% and 81.8%, respectively.
琉球医学会,Ryukyu Medical Associationの論文

[原著］三尖弁置換術における機械弁(SJM弁)と生体弁(CE弁)の比較検討 : 置換時期と早期および遠隔成績

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