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方法前瞻性分析了北美8个医疗中心共725例Freestyle无支架主动脉生物瓣置换术患者的临床疗效.其中668例(92%)患者年龄≥60岁.根据无支架主动脉生物瓣植入技术分为冠脉下植入术(SC)组、主动脉根部置换术(FR)组和主动脉内根部柱型植入术(RI)组,其中SC组509例(70.2%),平均年龄(72.3±7.6)岁;FR组178例(24.6%),平均年龄(70.6±8.1)岁;RI组38例(5.2%),平均年龄(69.4±10.6)岁.研究内容主要包括出院30天内、术后3～6个月、术后1年的临床和超声心动图资料及以后每年的临床和每两年的超声心动图资料. 结果平均随访6.2年,共4888人·年,失访47例,随访率93.5%.3组生存率、瓣膜相关死亡率、瓣膜结构损坏率、再手术率无显着差异. 术后1、8、10年平均跨瓣压差(MPG)SC组分别为(8.2±5.4)mmHg、(8.2±5.7)mmHg和(8.9±7.9)mmHg,FR组分别为(5.2±3.6)mmHg、(5.8±4.2)mmHg和(7.0±4.1)mm-
METHODS: A total of 725 patients with Freestyle stent-free aortic bioprosthesis in eight centers in North America were prospectively analyzed, of whom 668 (92%) were over 60 years old.According to the technique of stent-less aortic valve bioprosthesis (SC) group, aortic root replacement (FR) group and intra-aortic root columnar implantation (RI) group, including 509 cases (70.2%) in SC group, mean age ( 72.3 ± 7.6), 178 cases (24.6%) in FR group, with an average age of 70.6 ± 8.1 years and 38 cases (5.2%) in RI group, with an average age of 69.4 ± 10.6 years. Clinical and echocardiographic data of 1 to 6 months postoperatively and 1 year postoperatively were collected and clinically and biannually echocardiographic data were obtained.Results The mean follow-up was 6.2 years, 4888 person-years and 47 cases were lost to follow-up , And the follow-up rate was 93.5% .There was no significant difference in survival rate, valve-related mortality rate, valve structure damage rate and reoperation rate among the three groups.At 1, 8 and 10 years after operation, mean transvalvular pressure (MPG) (5.2 ± 3.6) mmHg, (5.8 ± 4.2) mmHg, and (7.0 ± 4.1) mmHg respectively in the FR group (8.2 ± 5.4 mmHg,