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本文引用的文献

1
Long-term outcomes of percutaneous mitral balloon valvuloplasty versus open cardiac surgery.经皮二尖瓣球囊成形术与心脏直视手术的长期结果比较。
J Thorac Cardiovasc Surg. 2010 Jan;139(1):103-10. doi: 10.1016/j.jtcvs.2009.04.022. Epub 2009 Jul 3.
2
Redo valvular surgery in elderly patients.老年患者再次进行瓣膜手术。
Ann Thorac Surg. 2009 Feb;87(2):521-5. doi: 10.1016/j.athoracsur.2008.09.030.
3
Mitral valve replacements in redo patients with previous mitral valve procedures: mid-term results and risk factors for survival.
J Card Surg. 2008 Sep-Oct;23(5):415-21. doi: 10.1111/j.1540-8191.2008.00630.x.
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Meta-analysis of clinical outcomes following surgical mitral valve repair or replacement.二尖瓣手术修复或置换术后临床结局的荟萃分析。
Eur J Cardiothorac Surg. 2007 Feb;31(2):267-75. doi: 10.1016/j.ejcts.2006.11.014. Epub 2006 Dec 18.
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Redo mitral valve surgery-a long-term experience.
J Card Surg. 2004 Jul-Aug;19(4):303-7. doi: 10.1111/j.0886-0440.2004.4054_11.x.
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Reoperation for prosthetic heart valve dysfunction: 19 years' experience.人工心脏瓣膜功能障碍再次手术：19年经验
Tex Heart Inst J. 1990;17(2):106-11.
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Risk of repeat mitral valve replacement for failed mitral valve prostheses.
Ann Thorac Surg. 2004 Jul;78(1):67-72; discussion 67-72. doi: 10.1016/j.athoracsur.2004.02.014.
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Surgical correction of aortic insufficiency.主动脉瓣关闭不全的外科矫正术。
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Reoperation for bioprosthetic mitral structural failure: risk assessment.生物人工二尖瓣结构功能衰竭的再次手术：风险评估
Circulation. 2003 Sep 9;108 Suppl 1:II98-102. doi: 10.1161/01.cir.0000089184.46999.f4.
10
Repeat heart valve surgery: risk factors for operative mortality.再次心脏瓣膜手术：手术死亡率的危险因素
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成人患者再次二尖瓣置换术后的结局：一项为期10年的单中心经验。

Outcome after redo-mitral valve replacement in adult patients: a 10-year single-centre experience.

作者信息

Vohra Hunaid A, Whistance Robert N, Roubelakis Apostolos, Burton Andrew, Barlow Clifford W, Tsang Geoffrey M K, Livesey Steve A, Ohri Sunil K

机构信息

Wessex Cardiothoracic Centre, Southampton University Hospitals NHS Trust, Southampton, UK.

出版信息

Interact Cardiovasc Thorac Surg. 2012 May;14(5):575-9. doi: 10.1093/icvts/ivs005. Epub 2012 Jan 31.

DOI:10.1093/icvts/ivs005
PMID:22294560
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3735849/
Abstract

The aim of this study was to investigate the overall outcome of adult patients undergoing redo-mitral valve replacement (redo-MVR) at our institution. Forty-nine patients (24 males) underwent redo-MVR with either bioprosthetic (n = 24) or mechanical valves (n = 25) between January 2000 and 2010. Median age of patients was 63 years (range 21-80 years), and the mean additive EuroSCORE was 12 ± 4. Median time to re-operation was 8.2 ± 6.6 years for first time redo-MVR and 6.4 ± 5.6 years for second-time redo-MVR. Indications included prosthetic endocarditis (n = 22), para-prosthetic leak (n = 12), structural valve degeneration (n = 8), prosthetic valve thrombosis (n = 6) and malignancy (n = 1). The mean follow-up was 47.5 ± 37.0 months (range 0.1-112.3 months). In-hospital mortality was 12% (n = 6). Mean hospital stay was 17 ± 11 days (range 8-50 days). Actuarial survival at 1 and 5 years was 81 ± 5% and 72 ± 6%, respectively. Three patients required re-intervention: two for prosthetic valve endocarditis and one for para-prosthetic leak. Multivariate analysis showed that overall survival was associated with the LVEF < 50% (P < 0.001), concomitant AVR (P < 0.001) and urgent surgery (P = 0.03).

摘要

本研究的目的是调查在我们机构接受再次二尖瓣置换术（redo-MVR）的成年患者的总体结局。2000年1月至2010年期间，49例患者（24例男性）接受了生物瓣膜（n = 24）或机械瓣膜（n = 25）的再次二尖瓣置换术。患者的中位年龄为63岁（范围21 - 80岁），平均附加欧洲心脏手术风险评估系统（EuroSCORE）评分为12±4。首次再次二尖瓣置换术的再次手术中位时间为8.2±6.6年，第二次再次二尖瓣置换术为6.4±5.6年。适应症包括人工瓣膜心内膜炎（n = 22）、人工瓣膜旁漏（n = 12）、结构性瓣膜退变（n = 8）、人工瓣膜血栓形成（n = 6）和恶性肿瘤（n = 1）。平均随访时间为47.5±37.0个月（范围0.1 - 112.3个月）。住院死亡率为12%（n = 6）。平均住院时间为17±11天（范围8 - 50天）。1年和5年的精算生存率分别为81±5%和72±6%。3例患者需要再次干预：2例因人工瓣膜心内膜炎，1例因人工瓣膜旁漏。多因素分析显示，总体生存与左心室射血分数（LVEF）<50%（P < 0.001）、同期主动脉瓣置换术（AVR）（P < 0.001）和急诊手术（P = 0.03）相关。