Is tricuspid valve replacement a catastrophic operation?

被引:60
作者
Sung, Kiick [1 ]
Park, Pyo Won [1 ]
Park, Kay-Hyun [2 ]
Jun, Tae-Gook [1 ]
Lee, Young Tak [1 ]
Yang, Ji-Hyuk [1 ]
Kim, Wook Sung [1 ]
Hwang, Joomin [1 ]
机构
[1] Sungkyunkwan Univ, Sch Med, Samsung Med Ctr, Dept Thorac & Cardiovasc Surg, Seoul 135710, South Korea
[2] Seoul Natl Univ, Bundang Hosp, Dept Thorac & Cardiovasc Surg, Seongam 463707, Gyeonggi Do, South Korea
关键词
Tricuspid valve replacement; Operative mortality; Operative morbidity; Survival; VENTRICULAR SYSTOLIC FUNCTION; OPEN-HEART-SURGERY; MODIFIED ULTRAFILTRATION; MORTALITY; INFANTS; DISEASE;
D O I
10.1016/j.ejcts.2009.04.063
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objective: Tricuspid valve replacement (TVR) has a high postoperative mortality, despite recent advances in perioperative care. We report the results of our experience in TVR with an emphasis on early mortality and morbidity and long-term follow-up. Methods: Between October 1994 and August 2007, 80 consecutive TVRs were performed in 78 patients. The mean age was 48 14 (range: 20-70) years. The underlying disease of the patients was classified as rheumatic (n = 54), congenital (n = 12), endocarditis (n = 10) or degenerative (n = 4). Previous cardiac surgery had been performed in 40 patients (50%). Isolated TVR was performed in 24 patients (30%). Results: Hospital mortality occurred in one patient (1.4%). Postoperative morbidities included intra-aortic balloon pump (n = 5), bleeding re-operation (n = 4), delayed sternal closure (n = 3), acute renal failure (n = 3), subdural. haematoma (n = 3), extracorporeal membrane oxygenation (n = 1), mediastinitis (n = 1) and pacemaker insertion (n = 4). In 42 patients, ventilator support was needed for more than 72 h. Based on multivariate analysis, age (p < 0.001) and the cardiopulmonary time (p = 0.004) were the identified risk factors. Follow-up was completed in all patients with a mean duration of 56 +/- 37 (range: 0-158) months. During the follow-up period, there were seven deaths (8.8%), including five cardiac deaths. The 5- and 8-year survival rates were 95 +/- 3% and 79 +/- 9% and event-free survival rates were 76 +/- 6% and 61 +/- 9%, respectively. Based on multivariate analysis, the only identified predictors of late deaths was a postoperative tow cardiac output (p = 0.024). Conclusions: TVR can be performed and low operative mortality can be achieved thorough optimal perioperative management in the current era. (C) 2009 European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved.
引用
收藏
页码:825 / 829
页数:5
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