Brescia Alexander A, Watt Tessa M F, Williams Aaron M, Romano Matthew A, Bolling Steven F
Department of Cardiac Surgery, University of Michigan, Ann Arbor, MI.
Oper Tech Thorac Cardiovasc Surg. 2019 Winter;24(4):206-218. doi: 10.1053/j.optechstcvs.2019.09.002. Epub 2019 Oct 25.
Intravenous drug use has increased substantially over the past decade, with heroin abuse more than doubling. Injection drug use-related infective endocarditis hospitalizations have similarly increased over the same period. Right-sided infective endocarditis is strongly associated with intravenous drug use, and 90% of right-sided endocarditis involves the tricuspid valve. During the period of the opioid epidemic, tricuspid-related endocarditis rates have increased, while the incidence of surgery for tricuspid endocarditis has increased as much as five-fold. Within this context, optimizing surgical technique for valve repair is increasingly important. In this report, we examine the indications for tricuspid valve surgery for endocarditis, describe specific techniques for tricuspid valve leaflet repair and augmentation, and assess postoperative care and surgical outcomes after both tricuspid valve repair and replacement for infective endocarditis.
在过去十年中,静脉注射吸毒现象大幅增加,海洛因滥用情况增加了一倍多。同期,与注射吸毒相关的感染性心内膜炎住院病例也同样增加。右侧感染性心内膜炎与静脉注射吸毒密切相关,90%的右侧心内膜炎累及三尖瓣。在阿片类药物流行期间,三尖瓣相关的心内膜炎发病率有所上升,而三尖瓣心内膜炎的手术发生率增加了多达五倍。在此背景下,优化瓣膜修复手术技术变得越来越重要。在本报告中,我们研究了感染性心内膜炎三尖瓣手术的适应症,描述了三尖瓣瓣叶修复和扩大的具体技术,并评估了感染性心内膜炎三尖瓣修复和置换术后的护理及手术结果。