Rodríguez-Capitán Jorge, Gómez-Doblas Juan J, Fernández-López Leticia, López-Salguero Raúl, Ruiz Manuel, Leruite Inés, Cabrera-Bueno Fernando, Mataró-López María J, Sánchez-Espín Gemma, Melero-Tejedor José M, Porras-Martín Carlos, Such Miguel, de Teresa Eduardo
Área del Corazón, Hospital Universitario Virgen de la Victoria, Málaga, Spain.
Área del Corazón, Hospital Universitario Virgen de la Victoria, Málaga, Spain.
Rev Esp Cardiol (Engl Ed). 2013 Aug;66(8):629-35. doi: 10.1016/j.rec.2013.02.002. Epub 2013 May 25.
There is little data available for Spain on the outcomes of surgical treatment for severe tricuspid regurgitation. The aim of this study was to analyze clinical and echocardiographic outcomes in a series of patients who received surgical treatment for severe tricuspid regurgitation and to compare outcomes according to the operative approach to valve repair or replacement.
Retrospective study in 119 consecutive patients with severe tricuspid regurgitation undergoing valve surgery between April 1996 and February 2010.
A total of 61 ringless and 23 ring annuloplasties were performed and 11 bioprostheses and 24 mechanical prostheses were implanted. Perioperative mortality was 18.5% and was associated with age and cardiopulmonary bypass time. During clinical follow-up (median, 41 [interquartile range, 24-89] months), 2 reoperations were required in the ring annuloplasty and mechanical prosthesis groups; prosthetic thrombosis was diagnosed in 4 patients in the latter group. Total mortality after follow-up was 29.9% and was associated with age>70 years and extracorporeal circulation time. The emergence of new severe tricuspid regurgitation was associated with age and ringless annuloplasty (P=.04).
Ringless repair was significantly associated with recurrence of severe tricuspid regurgitation. The use of mechanical prostheses was associated with a high rate of thrombosis. No significant differences in perioperative or total mortality were found between the different methods used for repair or valve replacement.
西班牙关于严重三尖瓣反流手术治疗结果的数据很少。本研究的目的是分析一系列接受严重三尖瓣反流手术治疗患者的临床和超声心动图结果，并根据瓣膜修复或置换的手术方法比较结果。
对1996年4月至2010年2月期间连续119例接受瓣膜手术的严重三尖瓣反流患者进行回顾性研究。
共进行了61例无环和23例环成形术，并植入了11个生物假体和24个机械假体。围手术期死亡率为18.5%，与年龄和体外循环时间有关。在临床随访期间（中位数为41[四分位间距为24 - 89]个月），环成形术和机械假体组有2例需要再次手术；后一组有4例被诊断为人工瓣膜血栓形成。随访后的总死亡率为29.9%，与年龄>70岁和体外循环时间有关。新的严重三尖瓣反流的出现与年龄和无环成形术有关（P = 0.04）。
无环修复与严重三尖瓣反流的复发显著相关。机械假体的使用与高血栓形成率有关。在用于修复或瓣膜置换的不同方法之间，围手术期或总死亡率没有显著差异。
