Merin G, Borman J B, Stern S, Davidson J T
Isr J Med Sci. 1975 Feb-Mar;11(2-3):197-202.
Sixty patients underwent repair or replacement of the tricuspid valve, 58 for acquired and two for congenital lesions. In 59 of the cases, the tricuspid surgery formed part of multiple valve surgery. Preoperatively, 33 patients (55%) were in New York Heart Association class IV and 25 in class III functional capacity. The tricuspid valve was replaced in 42 patients and repaired in 18. Forty-seven patients (78%) survived operation, but 10 of these died during a follow-up period of two to seven years. Thirty-four of the 37 long-term survivors show marked improvement. Operative mortality was 26% for tricuspid valve replacement and 11% for repair; late mortality was 14% and 22%, respectively. It should be stressed that the tricuspid valve replacement group consisted of patients whose preoperative condition was worse and whose valvular pathology was more severe than that of those who had tricuspid repair. In view of this, and the better long-term results of tricuspid valve replacement, it is concluded that the procedure of choice for serious organic disease of the tricuspid valve is valve replacement.
60例患者接受了三尖瓣修复或置换手术，其中58例为后天性病变，2例为先天性病变。59例患者中，三尖瓣手术是多瓣膜手术的一部分。术前，33例患者（55%）纽约心脏协会心功能分级为IV级，25例为III级。42例患者接受了三尖瓣置换，18例接受了修复。47例患者（78%）术后存活，但其中10例在2至7年的随访期内死亡。37例长期存活者中有34例有明显改善。三尖瓣置换术的手术死亡率为26%，修复术为11%；晚期死亡率分别为14%和22%。应当强调的是，三尖瓣置换组患者的术前状况比接受三尖瓣修复的患者更差，瓣膜病变也更严重。鉴于此，以及三尖瓣置换术更好的长期效果，可以得出结论，三尖瓣严重器质性疾病的首选治疗方法是瓣膜置换。
