Sala Alessandra, Lorusso Roberto, Alfieri Ottavio
Vita-Salute San Raffaele University, Department of Cardiac Surgery, IRCCS San Raffaele Hospital, Milan, Italy.
Cardio-Thoracic Surgery Department, Heart & Vascular Centre, Maastricht University Medical Centre (MUMC), Maastricht, the Netherlands; Cardiovascular Research Institute Maastricht (CARIM), Maastricht, the Netherlands.
Int J Cardiol. 2022 Apr 15;353:80-85. doi: 10.1016/j.ijcard.2022.01.069. Epub 2022 Feb 4.
Isolated tricuspid regurgitation (TR) is gaining increasing recognition. Left untreated, isolated TR significantly worsens survival. Management of patients with severe isolated TR remains controversial and stand-alone surgery is rarely performed due to reported high in-hospital mortality. However, recent data has underlined how early referral and surgical correction result in excellent both short-and long-term results, with no in-hospital mortality, 100% 5-year survival and no further hospitalizations for right heart failure. These results should prompt a drastic change in attitude in the treatment, management and referral of patients with severe isolated TR, especially since surgery remains the only effective therapy.
孤立性三尖瓣反流(TR)越来越受到关注。若不治疗,孤立性TR会显著降低生存率。重度孤立性TR患者的治疗仍存在争议,由于报告的住院死亡率较高,单独手术很少进行。然而,最近的数据强调了早期转诊和手术矫正如何能带来出色的短期和长期效果,且无住院死亡、5年生存率达100%以及无因右心衰竭再次住院的情况。这些结果应促使在重度孤立性TR患者的治疗、管理和转诊方面的态度发生巨大转变,特别是因为手术仍然是唯一有效的治疗方法。