Rossello Xavier, Muñoz-Guijosa Christian, Mena Elisabet, Camprecios Marta, Mendez Ana B, Borras Xavier, Padro Josep M
Department of Cardiology, Universitat Autònoma de Barcelona, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
Department of Cardiac Surgery, Universitat Autònoma de Barcelona, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
J Card Surg. 2017 Sep;32(9):542-549. doi: 10.1111/jocs.13193. Epub 2017 Aug 9.
Tricuspid valve replacement has been associated with high mortality and poor long-term outcomes. We report the preoperative risk factors associated with short and long-term outcomes following tricuspid valve replacement with mechanical prostheses.
In 62 patients who underwent mechanical tricuspid valve replacement, clinical, laboratory, and echocardiographic findings were analyzed using both univariate and multivariate analyses to describe operative and long-term mortality.
In our population (mean age 59 ± 9.7 years, 82.3% female), most common causes of tricuspid valve disease were rheumatic fever (69.4%) and functional regurgitation (19.4%). Operative and long-term mortality were 17.7 and 33.9%, respectively. Age, diabetes mellitus, and coronary artery disease were independently associated with increased long-term mortality. New York Heart Association (NYHA) class and right heart failure symptoms significantly improved during follow-up.
In this series of mechanical tricuspid valve replacements in patients with predominately rheumatic heart disease, operative and long-term mortality were increased; however, survivors had significant improvement in their NYHA class and freedom from right heart failure symptoms. Three preoperative factors (age, diabetes mellitus, and coronary artery disease) were independently associated with long-term mortality.
三尖瓣置换术与高死亡率及不良的长期预后相关。我们报告了机械瓣膜置换三尖瓣术后短期和长期预后的术前危险因素。
对62例行机械瓣膜置换三尖瓣术的患者，采用单因素和多因素分析方法，分析其临床、实验室及超声心动图检查结果，以描述手术及长期死亡率。
在我们的研究人群中（平均年龄59±9.7岁，82.3%为女性），三尖瓣疾病最常见的病因是风湿热（69.4%）和功能性反流（19.4%）。手术死亡率和长期死亡率分别为17.7%和33.9%。年龄、糖尿病和冠状动脉疾病与长期死亡率增加独立相关。纽约心脏协会（NYHA）心功能分级和右心衰竭症状在随访期间显著改善。
在这组以风湿性心脏病为主的患者行机械瓣膜置换三尖瓣术中，手术死亡率和长期死亡率均升高；然而，存活者的NYHA心功能分级显著改善，且无右心衰竭症状。三个术前因素（年龄、糖尿病和冠状动脉疾病）与长期死亡率独立相关。
