Title: Prosthetic Heart Valves
题目：人工心脏瓣膜
Author 作者: Semhar Tewelde
 
90,000 artificial heart valves are implanted yearly USA/ 280,000 yearly worldwide
美国每年有9万个人工心脏瓣膜的置入，全世界有28万。
 
Mechanical Valves (synthetic material)
机械瓣膜（合成材料）
  *Caged Ball 
*笼罩球瓣
  *Monoleaflet (tilting disc)
*单瓣膜（倾斜盘）
  *Bileaflet
*双瓣膜
High risk of thromboembolism
血栓形成和栓塞的危险度高
Requires lifelong anticoagulation
需要一生的抗凝治疗
Good long term durability
瓣膜寿命长
 
Bioprosthetic/Xenograft Valves (biological tissue)
生物／异体瓣膜 （生物组织）

  *Porcine
*猪
  *Bovine
*牛
Low risk of thromboembolism
血栓形成和栓塞的危险度低
No long term anticoagulation
不需要抗凝治疗
Poor long term durability (especially in young and pregnant populations) 
瓣膜寿命短（尤其对于年轻和怀孕的病人）
 
Complications
合并症

Primary valve failure  
瓣膜功能衰竭
Endocarditis
心内膜炎
Thrombus/Embolus
血栓／栓塞
Mechanical hemolytic anemia
机械性溶血性贫血
Anticoagulation related hemorrhage
与抗凝治疗有关的出血
Myocardial abscess
心肌内脓肿
  *New atrioventricular (AV) block + artificial valve = myocardial abscess (until proven otherwise)
*新发生的房室传导阻滞＋人工瓣膜＝心肌内脓肿（直到有确凿证据）

References 参考文献
Pibarot P, Dumesnil J. Prosthetic Heart Valves: Selection of the Optimal Prosthesis and Long-Term Management. Circulation. Vol 119(7); 24 Feb 2009, pp 1034-1048.