Medico-Surgical Department (Valvulopathies, Cardiac Surgery, Adult Interventional Cardiology), Hôpital Cardiologique de Haut-Lévèque, Bordeaux University Hospital, Pessac, France.
Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium.
Eur J Cardiothorac Surg. 2023 Jun 1;63(6). doi: 10.1093/ejcts/ezad201.
The aim of this study was to investigate the long-term outcomes of concomitant suture bicuspidization to treat mild or moderate tricuspid regurgitation at the time of mitral valve (MV) surgery.
Data from patients who underwent MV surgery for degenerative MV regurgitation with mild or moderate tricuspid regurgitation and annular dilatation between January 2009 and December 2017 were analysed. The cohort was divided into 2 groups: mitral valve surgery alone (MVA) and MV surgery with concomitant tricuspid valve (TV) repair.
A total of 196 patients were included in the study. MVA and MV surgery with concomitant TV repair were performed in 91 (46.4%) and 105 (53.6%) patients, respectively. Propensity score matching analysis identified 54 pairs. In the matched cohort, 30-day mortality (0.0% vs 1.9%, P = 1.0) and new permanent pacemaker implantation (11.1% vs 7.4%, P = 0.740) did not differ significantly between groups. After a mean follow-up of 6.0 (2.8) years, MV surgery with concomitant TV repair was not associated with increased mortality risk compared to MVA (hazard ratio 1.04, 95% confidence interval 0.47-2.28, P = 0.927) with 10-year overall survival rates of 69.9% and 77.2%, respectively. Furthermore, MV surgery with concomitant TV repair was associated with a significantly reduced progression of TV regurgitation (P < 0.001).
Patients undergoing MV surgery with concomitant TV repair had similar 30-day and long-term survival, similar permanent pacemaker implantation rate and reduced progression of TV regurgitation compared to those undergoing MVA.
本研究旨在探讨在二尖瓣（MV）手术时行双瓣叶成形术同期治疗轻中度三尖瓣反流的长期结果。
分析 2009 年 1 月至 2017 年 12 月期间因退行性 MV 反流合并轻中度三尖瓣反流和瓣环扩张行 MV 手术的患者数据。该队列分为 2 组：单纯 MV 手术（MVA）和 MV 手术同期行三尖瓣（TV）修复。
共纳入 196 例患者。MVA 和 MV 手术同期行 TV 修复分别在 91（46.4%）和 105 例（53.6%）患者中进行。采用倾向评分匹配分析识别出 54 对。在匹配队列中，两组 30 天死亡率（0.0%比 1.9%，P=1.0）和新发永久性起搏器植入率（11.1%比 7.4%，P=0.740）无显著差异。在平均 6.0（2.8）年的随访后，与 MVA 相比，MV 手术同期行 TV 修复与死亡率增加无关（风险比 1.04，95%置信区间 0.47-2.28，P=0.927），10 年总生存率分别为 69.9%和 77.2%。此外，MV 手术同期行 TV 修复与 TV 反流的显著改善相关（P<0.001）。
与 MVA 相比，行 MV 手术同期行 TV 修复的患者 30 天和长期生存率相似，永久性起搏器植入率相似，TV 反流进展减少。
