孤立性三尖瓣心内膜炎的外科治疗：中期数据。

Surgical treatment of isolated tricuspid valve endocarditis: Midterm data.

机构信息

Department of Cardiovascular Surgery, German Heart Centre Munich, Technische Universität München, Munich, Germany.

Department of Cardiovascular Surgery, German Heart Centre Munich, Insure (Institute for Translational Cardiac Surgery), Technische Universität München, Munich, Germany.

出版信息

J Card Surg. 2022 Oct;37(10):2999-3005. doi: 10.1111/jocs.16741. Epub 2022 Jul 5.

DOI:10.1111/jocs.16741

PMID:35790024

Abstract

BACKGROUND

Isolated tricuspid valve endocarditis (TVE) is a rare disease which is managed medically in most patients. Only in specific cases, surgical intervention becomes necessary. Hence, data about surgical outcomes are sparse. This study reports on the operative experience in patients with isolated TVE over a period of 20 years.

METHODS

We retrospectively analyzed 32 patients with isolated TVE who underwent surgery from February 2001 to June 2021 at the German Heart Centre Munich.

RESULTS

Thirty-day mortality was 3.1%. Overall survival was 89.9± 5.5% at 1 year and 76.9 ± 8.5% at 5 years. Cumulative incidence for reoperation was 11.1 ± 6.0% at 5 years. Four patients (12.5%) were treated for recurrent endocarditis. Tricuspid valve repair (TVr) was achieved in 16 patients (50%). If the subvalvular apparatus (n = 10) was involved, tricuspid valve replacement was performed more frequently.

CONCLUSIONS

Mortality in patients with isolated TVE undergoing cardiac surgery is high. In half of the cases, TVr was achieved but was less likely in patients with affected subvalvular apparatus.

摘要

背景

孤立性三尖瓣心内膜炎（TVE）是一种罕见疾病，大多数患者采用药物治疗。仅在特定情况下才需要手术干预。因此，关于手术结果的数据较为匮乏。本研究报告了 20 年来德国慕尼黑心脏中心治疗孤立性 TVE 患者的手术经验。

方法

我们回顾性分析了 2001 年 2 月至 2021 年 6 月期间 32 例接受手术治疗的孤立性 TVE 患者的资料。

结果

术后 30 天死亡率为 3.1%。1 年总生存率为 89.9±5.5%，5 年总生存率为 76.9±8.5%。5 年时再次手术的累积发生率为 11.1±6.0%。4 例（12.5%）患者因复发性心内膜炎接受治疗。16 例（50%）患者接受了三尖瓣修复（TVr）。如果瓣下结构（n=10）受累，更常进行三尖瓣置换。