Sanfelippo P M, Giuliani E R, Danielson G K, Wallace R B, Pluth J R, McGoon D C
J Thorac Cardiovasc Surg. 1976 Mar;71(3):441-5.
The total experience (154 patients) with ball-valve (Starr-Edwards) replacement of the tricuspid valve, alone and in combination, through Dec. 31, 1971, at the Mayo Clinic is reviewed. The early mortality rate with isolated tricuspid replacement was twice that for tricuspid replacement combined with replacement of other valves. Among patients receiving three valves, those with "functional'' tricuspid insufficiency and those who were in New York Heart Association (N.Y.H.A.) Class IV preoperatively had a higher early mortality rate. The early mortality rate for the total group was 28%. Of those surviving tricuspid plus mitral valve replacement, 70% were alive at 3 years; at latest follow-up, 94% of those surviving were functionally improved. Of those surviving triple valve replacement, 56% were alive at 3 years; at latest follow-up, 93% of those surviving were functionally improved. Previous cardiac surgery with residual tricuspid valve dysfunction and severe disability, as judged by N.Y.H.A. class, influenced the outcome adversely. The experience reported here provides a standard against which never prostheses can be compared.
回顾了截至1971年12月31日在梅奥诊所单独或联合使用球瓣（斯塔尔-爱德华兹瓣）置换三尖瓣的全部病例（154例）。单纯三尖瓣置换的早期死亡率是三尖瓣置换联合其他瓣膜置换的两倍。在接受三个瓣膜置换的患者中，有“功能性”三尖瓣关闭不全的患者以及术前纽约心脏协会（NYHA）心功能IV级的患者早期死亡率较高。整个组的早期死亡率为28%。在三尖瓣加二尖瓣置换术后存活的患者中，70%在3年后仍存活；在最近一次随访时，存活患者中有94%功能得到改善。在接受三个瓣膜置换术后存活的患者中，56%在3年后仍存活；在最近一次随访时，存活患者中有93%功能得到改善。根据NYHA分级判断，既往心脏手术伴有残余三尖瓣功能障碍和严重残疾对结果有不利影响。此处报告的经验提供了一个可用于比较新型人工瓣膜的标准。
