Singer Mahmoud, Alkady Hesham, Mohsen Tarek, Roushdy Amr, Akl Alsayed Kamel, Mashaal Marwa
Department of Cardiothoracic Surgery, Cairo University, Cairo, Almaneal, Egypt.
Department of Cardiology, Cairo University, Cairo, Almaneal, Egypt.
Thorac Cardiovasc Surg. 2017 Dec;65(8):634-638. doi: 10.1055/s-0037-1606386. Epub 2017 Sep 18.
Tricuspid valve (TV) endocarditis may be associated with serious complications, and 25% of patients require surgical intervention. However, indications and outcomes of surgery are not clearly identified. In this study, 60 patients are retrospectively reviewed to determine preoperative predictors of surgical outcome.
Sixty patients with isolated TV endocarditis who underwent surgery in the period between January 2012 and December 2016 are reviewed retrospectively from the medical records of Cairo University Hospitals. Forty-two (70%) patients were males, and 18 (30%) were females with a mean age of 29.3 ± 10.6 years. Eleven patients had an underlying cardiac lesion, and 27 patients were intravenous (IV)-drug addicts.
TV repair could be done in nine (15%) patients, and the rest received TV replacement with biological valves. Twenty-four (40%) patients experienced postoperative complications. On multivariate analysis, a vegetation size >2.2 cm was a significant preoperative predictor for embolic complications and prolonged ventilation. In-hospital mortality occurred in 10 (16.67%) patients. Significant preoperative predictors of mortality were pulmonary embolization, congestive heart failure (HF), and the presence of pericardial effusion. During a mean follow-up period of 25 ± 12.6 months with echocardiography, two (4%) IV drug user patients developed recurrence of infection and needed reoperation.
Surgery for tricuspid valve endocarditis (TVE) can be performed with good early and mid-term results. A large size of vegetations >2.2 cm is a significant risk factor for embolic complications. Preoperative predictors of in-hospital mortality according to our study are pulmonary embolization, congestive heart failure, and pericardial effusion.
三尖瓣心内膜炎可能伴有严重并发症，25%的患者需要手术干预。然而，手术指征和结果尚不明确。本研究回顾性分析60例患者，以确定手术结果的术前预测因素。
回顾性分析2012年1月至2016年12月期间在开罗大学医院接受手术的60例孤立性三尖瓣心内膜炎患者的病历。42例（70%）为男性，18例（30%）为女性，平均年龄29.3±10.6岁。11例患者有潜在心脏病变，27例患者为静脉药物滥用者。
9例（15%）患者可行三尖瓣修复，其余患者接受生物瓣膜置换。24例（40%）患者出现术后并发症。多因素分析显示，赘生物大小>2.2 cm是栓塞并发症和通气时间延长的重要术前预测因素。10例（16.67%）患者发生院内死亡。死亡的重要术前预测因素为肺栓塞、充血性心力衰竭（HF）和心包积液。在平均25±12.6个月的超声心动图随访期内，2例（4%）静脉药物滥用患者感染复发，需要再次手术。
三尖瓣心内膜炎（TVE）手术可取得良好的早、中期效果。赘生物大小>2.2 cm是栓塞并发症的重要危险因素。根据本研究，院内死亡的术前预测因素为肺栓塞、充血性心力衰竭和心包积液。
