Kitamura M, Koyanagi H
Department of Cardiovascular Surgery, Heart Institute of Japan, Tokyo Women's Medical College, Japan.
Nihon Geka Gakkai Zasshi. 1998 Feb;99(2):96-8.
Based on the STS/AATS guidelines of 1996, we compared the long-term results after mitral (Re-MVR) and/or tricuspid valve re-replacement (Re-TVR) in a total 324 patients (Re-MVT 299.Re-MVT+TVR 19, and Re-TVR 6 patients) with those after initial valve replacement in 763 patients (MVR 741, MVR+TVR 6 and TVR 16 patients). The actuarial survival (AS), reoperation-free (RF), thromboembolism-free (TF), and freedom from all valve-related events (EF) rates at the 15th postoperative year were 69.3%, 82.4% 86.6%, and 48.9% after Re-MVR and 87.2%, 92.2%, 83.9%, and 61.4% after initial MVR, respectively. The only significant difference between the two MVR groups occurred in the RF proportion. Similarly, the incidence of valve-related events after Re-MVR+TVR or Re-TVR was the same as that after the initial operation for the respective valve lesions. These long-term results suggest that valve re-replacement for mitral and/or tricuspid valve lesions should be encouraged to the same extent as the initial operation.
根据1996年的STS/AATS指南,我们比较了324例患者(二尖瓣再次置换术[Re-MVR]299例、二尖瓣再次置换术+三尖瓣再次置换术[Re-MVT+TVR]19例、三尖瓣再次置换术[Re-TVR]6例)二尖瓣和/或三尖瓣再次置换术后的长期结果与763例患者(二尖瓣置换术[MVR]741例、二尖瓣置换术+三尖瓣置换术6例、三尖瓣置换术16例)初次瓣膜置换术后的长期结果。术后第15年,Re-MVR后的精算生存率(AS)、无再次手术率(RF)、无血栓栓塞率(TF)和无所有瓣膜相关事件率(EF)分别为69.3%、82.4%、86.6%和48.9%,初次MVR后分别为87.2%、92.2%、83.9%和61.4%。两组MVR之间唯一显著的差异在于RF比例。同样,Re-MVR+TVR或Re-TVR后瓣膜相关事件的发生率与相应瓣膜病变初次手术后的发生率相同。这些长期结果表明,二尖瓣和/或三尖瓣病变的瓣膜再次置换应与初次手术一样受到同等程度的鼓励。