Cho Won-Chul, Park Chong Bin, Kim Joon Bum, Jung Sung-Ho, Chung Cheol Hyun, Choo Suk Jung, Lee Jae Won
Department of Thoracic and Cardiovascular Surgery, Gangneung Asan Hospital, University of Ulsan, College of Medicine, Gangneung, Korea.
J Card Surg. 2013 May;28(3):212-7. doi: 10.1111/jocs.12093. Epub 2013 Mar 12.
The purpose of this study was to evaluate the clinical outcomes and risk of tricuspid valve replacements and to compare bioprosthetic versus mechanical valves.
Between 1991 and 2009, 104 consecutive patients (71 women; mean age, 57 ± 10.8 years) with tricuspid valvular disease underwent mechanical TVR (mechanical group; n = 59) or bioprosthetic TVR (bioprosthesis group; n = 45). Follow-up was complete in 97.1% (n = 101) with a median duration of 49.9 months (range 0-230 months).
Hospital mortality after mechanical TVR and bioprosthetic TVR was not different on adjusted analysis by propensity score. Ten-year actuarial survival after mechanical and bioprosthetic TVR was 83.9 ± 7.6% and 61.4 ± 9.1%, respectively (p = 0.004). However, there was also no significant difference in terms of adjusted analysis by propensity score (p = 0.084). No statistically significant difference was detected between mechanical and bioprosthetic valves in regard to event-free survival.
Mechanical TVR is not inferior to bioprosthetic TVR in terms of occurrence of valve-related events, especially anticoagulation-related complications.
本研究旨在评估三尖瓣置换术的临床结果和风险，并比较生物瓣膜与机械瓣膜。
1991年至2009年间，104例连续性三尖瓣疾病患者（71例女性；平均年龄57±10.8岁）接受了机械三尖瓣置换术（机械瓣膜组；n = 59）或生物瓣膜三尖瓣置换术（生物瓣膜组；n = 45）。97.1%（n = 101）的患者完成随访，中位随访时间为49.9个月（范围0 - 230个月）。
经倾向评分调整分析后，机械瓣膜三尖瓣置换术和生物瓣膜三尖瓣置换术后的医院死亡率无差异。机械瓣膜和生物瓣膜三尖瓣置换术后10年的精算生存率分别为83.9±7.6%和61.4±9.1%（p = 0.004）。然而，经倾向评分调整分析后也无显著差异（p = 0.084）。在无事件生存率方面，机械瓣膜和生物瓣膜之间未检测到统计学显著差异。
在瓣膜相关事件的发生方面，尤其是抗凝相关并发症方面，机械三尖瓣置换术并不劣于生物瓣膜三尖瓣置换术。
