Hausen B, Albes J M, Rohde R, Demertzis S, Mügge A, Schäfers H J
Division of Thoracic Surgery, Hannover Medical School, Germany.
Ann Thorac Surg. 1995 May;59(5):1134-40. doi: 10.1016/0003-4975(95)00089-4.
In the present report the prevalence, severity, and risk factors of tricuspid valve regurgitation (TR) in 251 heart transplant recipients have been analyzed retrospectively. Tricuspid valve function was studied by color-flow Doppler echocardiogram and annual heart catheterization. The presence or severity of TR was graded on a scale from 0 (no TR) to 4 (severe). Additional postoperative data included rate of rejection, number of endomyocardial biopsies, incidence of transplant vasculopathy, and preoperative and postoperative hemodynamics. The incidence of grade 3 TR increases from 5% at 1 year to 50% at 4 years after transplantation. Multivariate analysis showed rate of rejection and donor heart weight to be significant risk factors. The ischemic intervals as well as the preoperative and postoperative pulmonary hemodynamics did not affect the severity or prevalence of TR. These results indicate that various factors appear to have an impact on the development of TR and that the prevalence might be lowered by a reduction of the number of biopsies performed and when possible, oversizing of donor hearts.
在本报告中，对251例心脏移植受者三尖瓣反流（TR）的患病率、严重程度及危险因素进行了回顾性分析。通过彩色多普勒超声心动图和年度心导管检查来研究三尖瓣功能。TR的存在或严重程度按0（无TR）至4（严重）分级。其他术后数据包括排斥反应发生率、心内膜心肌活检次数、移植血管病变发生率以及术前和术后血流动力学。3级TR的发生率从移植后1年的5%增加到4年时的50%。多因素分析显示排斥反应发生率和供心重量是显著危险因素。缺血时间以及术前和术后肺血流动力学并未影响TR的严重程度或患病率。这些结果表明，多种因素似乎对TR的发生有影响，并且通过减少活检次数以及在可能的情况下选用尺寸更大的供心，患病率可能会降低。
