Dinh Nguyen Hoang, Chuong Pham Tran Viet, Hieu Le Chi, Thuan Phan Quang, Nam Nguyen Hoai
Department of Cardiovascular and Thoracic Surgery, Faculty of Medicine, University of Medicine and Pharmacy.
Department of Adult Cardiovascular Surgery, University Medical Center, Ho Chi Minh City, Vietnam.
Ann Med Surg (Lond). 2024 Apr 3;86(6):3325-3329. doi: 10.1097/MS9.0000000000002027. eCollection 2024 Jun.
This study aims to present the early and mid-term outcomes of combining minimally invasive mitral valve surgery (MIMVS) with tricuspid valve repair (TVR) at the authors' centre.
From January 2017 to March 2022, our centre treated a total of 67 patients with both MIMVS and TVR. Among these patients, 41 were women (61.2%), and 26 were men (38.8%). The average Euro SCORE II was 2.67±1.54%, and the patients had an average follow-up period of 25.45±16.2 months.
Pre-discharge echocardiography revealed no or mild TR in 82.8% of cases. The overall 30-day mortality rate was 4.5%, with 3 deaths. Five-year survival was 94.5%±3.2%. In patients with mild or moderate preoperative tricuspid regurgitation (TR), the 5-year survival rate was 95.7%±4.3%, while for those with severe TR, it was 93.7%±4.5% (=0.947).
The authors' 5-year experience demonstrates that the combination of MIMVS and TVR can be routinely performed with favourable perioperative and postoperative outcomes in patients undergoing non-high-risk surgery. Additionally, there is no significant difference in five-year survival between the severe TR and mild to moderate TR groups preoperatively.
本研究旨在介绍作者所在中心将微创二尖瓣手术(MIMVS)与三尖瓣修复术(TVR)相结合的早期和中期结果。
2017年1月至2022年3月,我们中心共治疗了67例同时接受MIMVS和TVR的患者。其中,女性41例(61.2%),男性26例(38.8%)。欧洲心脏手术风险评估系统(Euro SCORE)II平均为2.67±1.54%,患者平均随访期为25.45±16.2个月。
出院前超声心动图显示82.8%的病例无或仅有轻度三尖瓣反流(TR)。30天总死亡率为4.5%,有3例死亡。五年生存率为94.5%±3.2%。术前有轻度或中度三尖瓣反流(TR)的患者,五年生存率为95.7%±4.3%,而重度TR患者为93.7%±4.5%(P=0.947)。
作者的五年经验表明,对于接受非高风险手术的患者,MIMVS和TVR联合手术可常规进行,围手术期和术后结果良好。此外,术前重度TR组和轻度至中度TR组的五年生存率无显著差异。