Thorburn C W, Morgan J J, Shanahan M X, Chang V P
Am J Cardiol. 1983 Apr;51(7):1128-32. doi: 10.1016/0002-9149(83)90357-0.
Observations in 71 patients having tricuspid valve replacement over a 14-year period are described. The operative mortality rate was 10% and the actuarial survival rate was 73% at 5 years and 47% at 10 years. Survival was unaffected by the number of valves replaced or the type used (27 Starr-Edwards, 32 Björk-Shiley, 8 Lillehei-Kaster, and 4 porcine xenografts). Complications were common: 3 deaths were related to anticoagulation and 1 was due to a systemic embolus. Six patients required permanent pacing. There was a very high incidence of thrombosis of the prosthetic tricuspid valve. Twenty percent of the tilting disc valves thrombosed, compared with 4% of the Starr-Edwards valves (p less than 0.05). Symptoms of thrombosis were usually insidious, and its diagnosis was often delayed. There was a continuing risk of this complication, and presentation occurred up to 12 years after the original operation. Thrombolytic therapy with streptokinase was successful in 1 of 2 patients. Replacement of the thrombosed prosthetic valves was carried out without mortality in 8 patients.
描述了在14年期间对71例行三尖瓣置换术患者的观察结果。手术死亡率为10%，5年实际生存率为73%，10年为47%。生存率不受置换瓣膜数量或类型的影响（27个斯塔尔-爱德华兹瓣膜、32个比约克-希利瓣膜、8个 Lillehei-Kaster瓣膜和4个猪异种瓣膜）。并发症很常见：3例死亡与抗凝有关，1例死于全身性栓塞。6例患者需要永久起搏。人工三尖瓣血栓形成的发生率非常高。倾斜碟瓣有20%发生血栓形成，而斯塔尔-爱德华兹瓣膜为4%（p<0.05）。血栓形成的症状通常隐匿，其诊断常常延迟。这种并发症存在持续风险，在初次手术后长达12年仍有发生。2例患者中1例使用链激酶溶栓治疗成功。8例患者对血栓形成的人工瓣膜进行置换，无死亡发生。
