The First Affiliated Hospital of Sun Yat-sen University Department of Cardiothoracic Surgery ICU Guangzhou People's Republic of China Department of Cardiothoracic Surgery ICU, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, People's Republic of China.
The First Affiliated Hospital of Sun Yat-sen University Department of Cardiopulmonary Bypass Guangzhou People's Republic of China Department of Cardiopulmonary Bypass, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, People's Republic of China.
Braz J Cardiovasc Surg. 2020 Oct 1;35(5):644-653. doi: 10.21470/1678-9741-2019-0215.
To evaluate the mid-term survival rate after tricuspid valve replacement (TVR).
We retrospectively studied 110 consecutive patients who underwent TVR from January 2007 to November 2017. A survival analysis was performed with the Kaplan-Meier method and the log-rank test.
The median survival was 65.81 months. Mean age was 50 (range 39 to 59) years. Forty-eight patients (43.6%) were male, and 62 patients (56.4%) were female. Most of the patients (78.5%) were categorized into the New York Heart Association (NYHA) functional classes III/IV. Seventy-two patients (65.5%) had isolated TVR. Six-three patients (57.3%) had previously undergone heart surgery. The Kaplan-Meier survival rates at one year, three years, and five years were 59.0%±5%, 52.0%±6%, and 48.0%±6%, respectively. A Cox regression analysis demonstrated that the risk factors for mid-term mortality were advanced NYHA class (hazard ratio [HR] 2.430, 95% confidence interval [CI] 1.099-5.375, P=0.028), need for continuous renal replacement therapy (CRRT) treatment (HR 3.121, 95% CI 1.610-6.050, P=0.001), and need for intra-aortic balloon pump (IABP) treatment (HR 3.356, 95% CI 1.072-10.504, P=0.038).
In TVR, impaired cardiac function before the operation and a need for CRRT or IABP treatment after the operation is independently associated with increased mid-term mortality.
评估三尖瓣置换术（TVR）后的中期生存率。
我们回顾性研究了 2007 年 1 月至 2017 年 11 月期间连续 110 例接受 TVR 的患者。采用 Kaplan-Meier 方法和对数秩检验进行生存分析。
中位生存期为 65.81 个月。平均年龄为 50 岁（范围 39 至 59 岁）。48 例（43.6%）为男性，62 例（56.4%）为女性。大多数患者（78.5%）被归类为纽约心脏协会（NYHA）功能分级 III/IV 级。72 例（65.5%）患者行单纯 TVR。63 例（57.3%）患者曾行心脏手术。1 年、3 年和 5 年的 Kaplan-Meier 生存率分别为 59.0%±5%、52.0%±6%和 48.0%±6%。Cox 回归分析表明，中期死亡的危险因素是 NYHA 分级较高（危险比 [HR] 2.430，95%置信区间 [CI] 1.099-5.375，P=0.028）、需要持续肾脏替代治疗（CRRT）（HR 3.121，95%CI 1.610-6.050，P=0.001）和需要主动脉内球囊泵（IABP）治疗（HR 3.356，95%CI 1.072-10.504，P=0.038）。
在 TVR 中，术前心功能受损以及术后需要 CRRT 或 IABP 治疗与中期死亡率增加独立相关。
