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孤立性三尖瓣手术;基于德黑兰心脏中心数据库报告的长期结果。

Isolated tricuspid valve surgery; long-term outcomes based on Tehran Heart Center data bank report.

机构信息

Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.

Cardiovascular Research Center, Tehran University of Medical Sciences, Tehran, Iran.

出版信息

J Cardiothorac Surg. 2021 Feb 23;16(1):19. doi: 10.1186/s13019-021-01394-1.

Abstract

BACKGROUND

Given that isolated tricuspid valve (TV) repair or replacement is performed relatively rarely, we sought to evaluate the rate of long-term mortality and readmission following this surgery.

METHODS

The current study was conducted in Tehran Heart Center on patients who underwent isolated TV repair or replacement between 2010 and 2018. Totally, 197 patients (repair = 150 vs replacement = 47) were included in our study and were then followed right after surgery for a median of 8 years to assess the incidence of postoperative events, readmission, and all-cause mortality.

RESULTS

The final analysis was conducted on 197 patients at a mean age of 44.4 ± 13.8 years. Most of the patients were female (56.9%). Ejection fraction, TAPSE, and right ventricular function improved in both groups after TV surgery. Length of stay in the intensive care unit per hour and hospitalization per day were higher in the replacement group and compared to the repair group (158.34 vs. 55.11 and 18.21 vs. 9.34, respectively). In-hospital mortality occurred in 20 patients, of whom 15 had TV replacement. Readmission occurred in five (2.5%) patients,all were in the repair group.

CONCLUSIONS

The result of this single-center study showed that TV replacement is associated with a higher rate of postoperative events and all-cause mortality compared to TV repair. Whereas, repair group had a higher rate of readmission. Therefore, the overwhelming tendency is toward repair; nonetheless, no hesitation is permissible if a replacement is adjudged to confer a better outcome for the patient.

摘要

背景

鉴于孤立性三尖瓣(TV)修复或置换术相对较少进行,我们旨在评估此类手术后的长期死亡率和再入院率。

方法

本研究在德黑兰心脏中心进行,纳入 2010 年至 2018 年间接受孤立性 TV 修复或置换术的患者。共有 197 例患者(修复=150 例,置换=47 例)纳入本研究,随后对患者进行中位时间为 8 年的术后随访,以评估术后事件、再入院和全因死亡率的发生率。

结果

最终对 197 例患者进行了分析,平均年龄为 44.4±13.8 岁。大多数患者为女性(56.9%)。TV 手术后,两组的射血分数、TAPSE 和右心室功能均得到改善。与修复组相比,置换组的每小时 ICU 停留时间和每天住院时间均较高(158.34 比 55.11 和 18.21 比 9.34)。20 例患者院内死亡,其中 15 例接受了 TV 置换。5 例(2.5%)患者再入院,均在修复组。

结论

这项单中心研究的结果表明,与 TV 修复相比,TV 置换术后发生术后事件和全因死亡率的风险更高。然而,修复组的再入院率较高。因此,倾向于修复,但如果认为置换对患者的预后更好,也不应犹豫不决。

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本文引用的文献

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National Trends and Outcomes in Isolated Tricuspid Valve Surgery.孤立性三尖瓣手术的国家趋势和结果。
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