Dai Xiaoyi, Teng Peng, Miao Sihan, Zheng Junnan, Si Wei, Zheng Qi, Qin Ke, Ma Liang
Department of Cardiovascular Surgery, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
School of Medicine, Zhejiang University, Hangzhou, China.
Front Surg. 2022 Mar 25;9:837148. doi: 10.3389/fsurg.2022.837148. eCollection 2022.
Tricuspid regurgitation after left-sided valve surgery was associated with terrible outcomes and high perioperative mortality for surgical treatment. In current years, minimally invasive isolated tricuspid valve repair is increasingly performed in our institution to address tricuspid regurgitation.
Thirty-seven consecutive patients with previous left-sided valve surgery underwent minimally invasive isolated tricuspid valve repair in our institution between November 2017 and December 2020. Twenty-nine patients(78.4%) were women and the mean age of patients was 58.4 ± 8.5 years. Follow-up was 100% complete with a mean follow-up time of 17.2 ± 9.5 months.
Both the in-hospital and 30-day mortalities were 2.7%. The overall NYHA class had improved significantly during the follow-up ( < 0.001). The grade of TR had decreased before discharge ( < 0.001) and during the follow-up ( < 0.001) compared with the preoperative level although severe TR was recurrent in one patient.
Minimally invasive isolated tricuspid valve repair has acceptable early and midterm outcomes, may be the preferred surgical option to address tricuspid regurgitation after previous left-sided valve surgery when it is feasible.
左侧瓣膜手术后的三尖瓣反流与手术治疗的不良预后和高围手术期死亡率相关。近年来，我院越来越多地采用微创孤立性三尖瓣修复术来治疗三尖瓣反流。
2017年11月至2020年12月期间，我院对37例曾接受左侧瓣膜手术的患者进行了微创孤立性三尖瓣修复术。29例患者（78.4%）为女性，患者平均年龄为58.4±8.5岁。随访率为100%，平均随访时间为17.2±9.5个月。
住院死亡率和30天死亡率均为2.7%。随访期间纽约心脏协会（NYHA）心功能分级总体显著改善（<0.001）。与术前水平相比，出院前（<0.001）和随访期间（<0.001）三尖瓣反流（TR）分级均有所下降，尽管有1例患者出现严重TR复发。
微创孤立性三尖瓣修复术具有可接受的早期和中期疗效，在可行的情况下，可能是治疗既往左侧瓣膜手术后三尖瓣反流的首选手术方式。
