风湿性心脏病与非风湿性心脏病患者三尖瓣置换的病例对照研究_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

尹俊 ,  陈锁成 , 丁国文 , 董长青 , 孙扬永 , 施益军 , 朱静峰 , 邵爱中 , 刘超 , 龙涛

江苏大学附属人民医院心胸外科（江苏镇江 212002）;

Corresponding author：

陈锁成, Email: yin912@outlook.com

Keywords：

心脏瓣膜病; 三尖瓣置换; 回顾性分析

DOI：

10.7507/1007-4848.201705060

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

目的分析三尖瓣置换患者的流行病学特征、治疗及随访情况，探讨提高三尖瓣置换疗效的策略。方法回顾性分析 2009 年 8 月至 2016 年 10 月 20 例在我院行三尖瓣置换患者的临床资料。男 4 例、女 16 例，年龄 31～73（54.4±2.2）岁。根据病因学分为风湿性心脏病组（14 例）及非风湿性心脏病组（6 例），比较两组患者术前情况、治疗方法、治疗结果及随访情况的差异。结果本组围手术期死亡 3 例，住院病死率 15.0%。死亡原因均为多器官功能衰竭。术后对 17 例出院患者进行了随访，随访率 100.0%，随访时间 1～84 个月，随访期间共有 2 例死亡。风湿性疾病组与非风湿性疾病组术前存在心房颤动/心房扑动心律（P=0.001）、术前有心脏手术史（P=0.017）、手术中是否进行主动脉阻断（P=0.032）差异有统计学意义。结论尽管风险较大，三尖瓣置换仍是针对器质性三尖瓣病变的有效手段，但需严格掌握手术指征及手术时机。风湿性三尖瓣疾病具有更多的危险因素，尤其是既往有左心瓣膜手术史继发三尖瓣关闭不全的患者。

Citation： 尹俊, 陈锁成, 丁国文, 董长青, 孙扬永, 施益军, 朱静峰, 邵爱中, 刘超, 龙涛. 风湿性心脏病与非风湿性心脏病患者三尖瓣置换的病例对照研究. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2018, 25(4): 350-353. doi: 10.7507/1007-4848.201705060 Copy

1.	Singh SK, Tang GH, Maganti MD, et al. Midterm outcomes of tricuspid valve repair versus replacement for organic tricuspid disease. Ann Thorac Surg, 2006, 82(5): 1735-1741.
2.	Kaplan M, Kut MS, Demirtas MM, et al. Prosthetic replacement of tricuspid valve: bioprosthetic or mechanical. Ann Thorac Surg, 2002, 73(2): 467-473.
3.	McGrath LB, Gonzalez-Lavin L, Bailey BM, et al. Tricuspid valve operations in 530 patients. Twenty-five-year assessment of early and late phase events. J Thorac Cardiovasc Surg, 1990, 99(1): 124-133.
4.	Carrier M, Hebert Y, Pellerin M, et al. Tricuspid valve replacement: an analysis of 25 years of experience at a single center. Ann Thorac Surg, 2003, 75(1): 47-50.
5.	张宝仁, 朱家林, 主编. 人造心脏瓣膜与瓣膜置换术. 第 2 版: 人民卫生出版社, 2000. 389-399.
6.	Nishimura RA, Otto CM, Bonow RO, et al. 2014 AHA/ACC guideline for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Thorac Cardiovasc Surg, 2014, 148(1): e1-e132.
7.	张乐, 王崇, 张加俊, 等. 左心瓣膜置换术后重度三尖瓣关闭不全的内外科治疗比较及危险因素分析. 中国体外循环杂志, 2016, 14(2): 108-111.
8.	徐志云, 张宝仁, 邹良建, 等. 风湿性心脏病左心瓣膜置换术后晚期重度三尖瓣关闭不全的外科治疗. 中华胸心血管外科杂志, 2008, 24(6): 370-372.
9.	Iscan ZH, Vural KM, Bahar I, et al. What to expect after tricuspid valve replacement? Long-term results. Eur J Cardio-Thorac Surg, 2007, 32(2): 296-300.
10.	Filsoufi F, Anyanwu AC, Salzberg SP, et al. Long-term outcomes of tricuspid valve replacement in the current era. Ann Thorac Surg, 2005, 80(3): 845-850.
11.	Chang BC, Lim SH, Yi G, et al. Long-term clinical results of tricuspid valve replacement. Ann Thorac Surg, 2006, 81(4): 1317-1323.
12.	Guenther T, Noebauer C, Mazzitelli D, et al. Tricuspid valve surgery: a thirty-year assessment of early and late outcome. Eur J Cardio-Thorac Surg, 2008, 34(2): 402-409.
13.	Bernal JM, Ponton A, Diaz B, et al. Surgery for rheumatic tricuspid valve disease: a 30-year experience. J Thorac Cardiovasc Surg, 2008, 136(2): 476-481.
14.	张宝仁, 韩庆奇. 三尖瓣置换术的现状. 国际心血管病杂志, 2009, 36(6): 325-332.
15.	魏大闯, 黄焕雷, 卢聪, 等. 左心瓣膜置换术后孤立性三尖瓣关闭不全的外科治疗. 中国胸心血管外科临床杂志, 2014, 21(6): 178-182.
16.	Sung K, Park PW, Park KH, et al. Is tricuspid valve replacement a catastrophic operation? Eur J Cardio-Thorac Surg, 2009, 36(5): 825-829.
17.	Rizzoli G, Vendramin I, Nesseris G, et al. Biological or mechanical prostheses in tricuspid position? A meta-analysis of intra-institutional results. Ann Thorac Surg, 2004, 77(5): 1607-1614.

1. Singh SK, Tang GH, Maganti MD, et al. Midterm outcomes of tricuspid valve repair versus replacement for organic tricuspid disease. Ann Thorac Surg, 2006, 82(5): 1735-1741.
2. Kaplan M, Kut MS, Demirtas MM, et al. Prosthetic replacement of tricuspid valve: bioprosthetic or mechanical. Ann Thorac Surg, 2002, 73(2): 467-473.
3. McGrath LB, Gonzalez-Lavin L, Bailey BM, et al. Tricuspid valve operations in 530 patients. Twenty-five-year assessment of early and late phase events. J Thorac Cardiovasc Surg, 1990, 99(1): 124-133.
4. Carrier M, Hebert Y, Pellerin M, et al. Tricuspid valve replacement: an analysis of 25 years of experience at a single center. Ann Thorac Surg, 2003, 75(1): 47-50.
5. 张宝仁, 朱家林, 主编. 人造心脏瓣膜与瓣膜置换术. 第 2 版: 人民卫生出版社, 2000. 389-399.
6. Nishimura RA, Otto CM, Bonow RO, et al. 2014 AHA/ACC guideline for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Thorac Cardiovasc Surg, 2014, 148(1): e1-e132.
7. 张乐, 王崇, 张加俊, 等. 左心瓣膜置换术后重度三尖瓣关闭不全的内外科治疗比较及危险因素分析. 中国体外循环杂志, 2016, 14(2): 108-111.
8. 徐志云, 张宝仁, 邹良建, 等. 风湿性心脏病左心瓣膜置换术后晚期重度三尖瓣关闭不全的外科治疗. 中华胸心血管外科杂志, 2008, 24(6): 370-372.
9. Iscan ZH, Vural KM, Bahar I, et al. What to expect after tricuspid valve replacement? Long-term results. Eur J Cardio-Thorac Surg, 2007, 32(2): 296-300.
10. Filsoufi F, Anyanwu AC, Salzberg SP, et al. Long-term outcomes of tricuspid valve replacement in the current era. Ann Thorac Surg, 2005, 80(3): 845-850.
11. Chang BC, Lim SH, Yi G, et al. Long-term clinical results of tricuspid valve replacement. Ann Thorac Surg, 2006, 81(4): 1317-1323.
12. Guenther T, Noebauer C, Mazzitelli D, et al. Tricuspid valve surgery: a thirty-year assessment of early and late outcome. Eur J Cardio-Thorac Surg, 2008, 34(2): 402-409.
13. Bernal JM, Ponton A, Diaz B, et al. Surgery for rheumatic tricuspid valve disease: a 30-year experience. J Thorac Cardiovasc Surg, 2008, 136(2): 476-481.
14. 张宝仁, 韩庆奇. 三尖瓣置换术的现状. 国际心血管病杂志, 2009, 36(6): 325-332.
15. 魏大闯, 黄焕雷, 卢聪, 等. 左心瓣膜置换术后孤立性三尖瓣关闭不全的外科治疗. 中国胸心血管外科临床杂志, 2014, 21(6): 178-182.
16. Sung K, Park PW, Park KH, et al. Is tricuspid valve replacement a catastrophic operation? Eur J Cardio-Thorac Surg, 2009, 36(5): 825-829.
17. Rizzoli G, Vendramin I, Nesseris G, et al. Biological or mechanical prostheses in tricuspid position? A meta-analysis of intra-institutional results. Ann Thorac Surg, 2004, 77(5): 1607-1614.

Previous Article
Development of transcatheter intervention devices for tricuspid valve lesions
Next Article
医用胶在肺微小结节术前定位中的应用

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

风湿性心脏病与非风湿性心脏病患者三尖瓣置换的病例对照研究

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content