De Paulis R, Bobbio M, Ottino G, Donegani E, Di Rosa E, Casabona R, Girotto M, Morea M
Cattedra di Cardiochirurgia, Università degli Studi di Torino, Turin, Italy.
J Cardiovasc Surg (Torino). 1990 Jul-Aug;31(4):512-7.
One hundred and fifty-three patients undergoing De Vega tricuspid annuloplasty, with or without other associated cardiac procedures between January, 1979, and June, 1987, were evaluated. There were 136 hospital survivors. The follow-up was 98.1% complete for a mean of 3.7 years/patient. Operative mortality was 11.1%; preoperative NYHA class and length of CPB were significant risk factors of perioperative mortality. The actuarial survival of operative survivors at 9 years was 73.5 +/- 11.8%. There were 7 late cardiac deaths among a total of 12 late deaths. Eleven patients required reoperation (2.1 +/- 0.6% patient-year). In seven patients it was necessary for recurrence of tricuspid regurgitation; six of these had also a mitral prosthesis malfunction or a periprosthetic leak. Residual tricuspid regurgitation was judged as mild, moderate or severe in 29.9%, 11.9% and 4.3% of the patients respectively. De Vega tricuspid annuloplasty is the method of choice for mild and moderate tricuspid insufficiency; in selected cases, with a more severe degree of regurgitation, better results could be achieved with a different surgical approach.
对1979年1月至1987年6月期间接受德维加三尖瓣环成形术（无论是否合并其他心脏手术）的153例患者进行了评估。共有136例患者存活出院。随访完成率为98.1%，平均每位患者随访3.7年。手术死亡率为11.1%；术前纽约心脏协会（NYHA）心功能分级和体外循环时间是围手术期死亡的重要危险因素。手术存活者9年的精算生存率为73.5±11.8%。在总共12例晚期死亡病例中有7例为心脏原因导致的晚期死亡。11例患者需要再次手术（每年2.1±0.6%的患者）。7例患者因三尖瓣反流复发需要再次手术；其中6例还存在二尖瓣人工瓣膜功能障碍或人工瓣膜周漏。分别有29.9%、11.9%和4.3%的患者残余三尖瓣反流被判定为轻度、中度或重度。德维加三尖瓣环成形术是治疗轻、中度三尖瓣关闭不全的首选方法；在某些病例中，对于反流程度更严重的情况，采用不同的手术方法可能会取得更好的效果。
