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三尖瓣环成形术治疗功能性三尖瓣反流的长期结果。

Long-Term Results of Tricuspid Annuloplasty Using MC3 Ring for Functional Tricuspid Regurgitation.

机构信息

Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital.

出版信息

Circ J. 2018 Aug 24;82(9):2358-2363. doi: 10.1253/circj.CJ-18-0090. Epub 2018 Jul 3.

DOI:10.1253/circj.CJ-18-0090
PMID:29973430
Abstract

BACKGROUND

This study aimed to evaluate the long-term results of tricuspid annuloplasty using the MC3 ring for functional tricuspid regurgitation (TR).

METHODS AND RESULTS

Between 2004 and 2014, 249 patients underwent tricuspid ring annuloplasty using the MC3 ring for functional TR (FTR). Main etiologies of FTR were left-sided valvular disease (n=211) and left-to-right shunt (n=34). Based on the interval between the operation and last echocardiographic scan, patients were divided into short-term and long-term follow-up groups. Mean follow-up duration was 84.4±37.1 months. Operative death occurred in 8 patients (3.2%). Predischarge echocardiography showed that both TR grade and systolic pulmonary artery pressure were significantly decreased compared with preoperative values, and these values were sustained during follow-up in both the short-term and long-term follow-up groups. There were no ring-related complications in either the postoperative or follow-up period, except for permanent pacemaker implantation in 2 patients. The freedom from TR ≥moderate and tricuspid valve (TV)-related events at 10 years were 92.1% and 92.8%, respectively. TV annular size was a risk factor for the recurrence of TR ≥moderate (P=0.001), and 42 mm was the cutoff value for predicting the recurrence of TR ≥moderate.

CONCLUSIONS

Tricuspid annuloplasty using the MC3 ring for FTR provides satisfactory early results that are sustained during long-term follow-up. Preoperative TV annular size was associated with the recurrence of TR ≥moderate.

摘要

背景

本研究旨在评估 MC3 环在功能性三尖瓣反流(TR)中的三尖瓣环成形术的长期结果。

方法和结果

2004 年至 2014 年期间,249 例功能性 TR 患者接受了 MC3 环的三尖瓣环成形术。FTR 的主要病因是左侧瓣膜疾病(n=211)和左向右分流(n=34)。根据手术与最后一次超声心动图扫描之间的时间间隔,患者分为短期和长期随访组。平均随访时间为 84.4±37.1 个月。8 例患者(3.2%)发生围手术期死亡。出院时超声心动图显示,与术前相比,TR 分级和收缩期肺动脉压均显著降低,且在短期和长期随访组的随访期间均保持稳定。除 2 例患者植入永久性起搏器外,术后及随访期间均无环形相关并发症。10 年时无 TR≥中度和三尖瓣(TV)相关事件的比例分别为 92.1%和 92.8%。TV 环大小是 TR≥中度复发的危险因素(P=0.001),42mm 是预测 TR≥中度复发的截断值。

结论

MC3 环在 FTR 中的三尖瓣环成形术提供了令人满意的早期结果,并且在长期随访中得以维持。术前 TV 环大小与 TR≥中度复发相关。

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