Department of Cardiac Surgery, Zhongshan Hospital, Fudan University, Shanghai, China; Shanghai Engineering Research Center of Heart Valve, Shanghai, China; Shanghai Institute of Cardiovascular Disease, Shanghai, China.
Department of Cardiac Surgery, Zhongshan Hospital, Fudan University, Shanghai, China; Shanghai Engineering Research Center of Heart Valve, Shanghai, China; Shanghai Institute of Cardiovascular Disease, Shanghai, China.
Ann Thorac Surg. 2021 May;111(5):e381-e383. doi: 10.1016/j.athoracsur.2020.08.091. Epub 2020 Nov 17.
Late severe tricuspid regurgitation after left-sided valve surgery can negatively affect long-term prognosis and quality of life. Because of extensive surgical trauma and poor right heart function, perioperative mortality after reoperation for tricuspid regurgitation historically remained high. A number of minimally invasive techniques were adopted at our center recently, including endoscopy-assisted right minithoracotomy, vacuum-assisted single femoral venous drainage without dissecting or snaring vena cava, direct right atriotomy through pericardium, and the beating-heart technique. Moreover, the tricuspid valves were replaced with bioprostheses in the majority of those patients at our center. The midterm outcomes of minimally invasive bioprosthetic tricuspid valve replacement were favorable.
左侧心脏瓣膜手术后晚期严重三尖瓣反流可对长期预后和生活质量产生负面影响。由于手术创伤广泛且右心功能不良,三尖瓣反流再次手术的围手术期死亡率一直居高不下。最近我们中心采用了一些微创技术,包括内镜辅助右小开胸术、不解剖或套扎腔静脉的真空辅助单股股静脉引流、经心包直接右心房切开术和心脏不停跳技术。此外,我们中心的大多数患者都采用生物瓣置换三尖瓣。微创生物瓣置换术的中期结果是良好的。