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《2022年左侧瓣膜手术后孤立性三尖瓣反流管理的CMICS专家共识》

2022 CMICS Expert Consensus on the Management of Isolated Tricuspid Regurgitation after Left-Sided Valve Surgery.

作者信息

Chen Jinmiao, Cheng Zhaoyun, Dong Nianguo, Dong Lili, Guo Huiming, Guo Yingqiang, Huang Huanlei, Jiang Shengli, Lu Fanglin, Li Fei, Liu Jinping, Liu Liming, Li Xin, Mei Ju, Ma Liang, Qiao Chenhui, Sun Lizhong, Tu Guowei, Tao Liang, Wang Dongjin, Wang Huishan, Wei Minxin, Wan Song, Xu Jianjun, Xue Song, Zheng Zhe, Wei Lai, Wang Chunsheng

机构信息

Department of Cardiovascular Surgery, Zhongshan Hospital, Fudan University, 200032 Shanghai, China.

Department of Cardiovascular Surgery, Fuwai Central China Cardiovascular Hospital, 451464 Zhengzhou, Henan, China.

出版信息

Rev Cardiovasc Med. 2023 Apr 26;24(5):129. doi: 10.31083/j.rcm2405129. eCollection 2023 May.

Abstract

Tricuspid regurgitation (TR) may occur late after left-sided valve surgery (LSVS). Isolated tricuspid regurgitation after left-sided valve surgery (iTR-LSVS) refers to isolated TR without significant lesions in the mitral and/or aortic position late after mitral and/or aortic replacement or repair. Severe TR has a negative impact on long-term prognosis and requires surgical or transcatheter treatment. However, there is no clear recommendation on when and how intervention should be performed for patients with iTR-LSVS in the current guidelines for the management of valvular heart disease. The historically high operative mortality may be reduced by current minimally invasive techniques and transcatheter therapy. To further understand iTR-LSVS, standardize the treatment, improve the prognosis, and promote the collaboration, the Chinese Minimally Invasive Cardiovascular Surgery Committee (CMICS) wrote this expert consensus on the management of iTR-LSVS from the aspects of etiology, preoperative evaluation, indications for intervention, surgical treatment, transcatheter therapy, and postoperative management.

摘要

三尖瓣反流(TR)可能在左侧瓣膜手术后较晚出现。左侧瓣膜手术后的孤立性三尖瓣反流(iTR-LSVS)是指在二尖瓣和/或主动脉瓣置换或修复术后较晚出现的、二尖瓣和/或主动脉瓣位置无明显病变的孤立性TR。严重TR对长期预后有负面影响,需要手术或经导管治疗。然而,在目前的心脏瓣膜病管理指南中,对于iTR-LSVS患者何时以及如何进行干预尚无明确建议。当前的微创技术和经导管治疗可能会降低历来较高的手术死亡率。为进一步了解iTR-LSVS,规范治疗,改善预后,并促进协作,中国微创心血管外科委员会(CMICS)从病因、术前评估、干预指征、手术治疗、经导管治疗及术后管理等方面撰写了本关于iTR-LSVS管理的专家共识。

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Tricuspid regurgitation: when is it time for surgery?三尖瓣反流:何时需要手术?
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本文引用的文献

1
Transcatheter Repair for Patients with Tricuspid Regurgitation.经导管三尖瓣反流修复术治疗患者。
N Engl J Med. 2023 May 18;388(20):1833-1842. doi: 10.1056/NEJMoa2300525. Epub 2023 Mar 4.
4

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