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首页> 外文期刊>Circulation journal >Fate of Functional Tricuspid Regurgitation After Mitral Valve Repair for Degenerative Mitral Regurgitation
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Fate of Functional Tricuspid Regurgitation After Mitral Valve Repair for Degenerative Mitral Regurgitation

机译：二尖瓣修复性退行性二尖瓣关闭不全的功能性三尖瓣关闭不全的命运

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Background: ?The issue of whether functional tricuspid regurgitation (TR) should be repaired at the time of mitral valve surgery is controversial, and the long-term durability of tricuspid valve (TV) annuloplasty remains unknown. Methods and Results: ?We retrospectively reviewed 654 patients who underwent mitral valve repair for degenerative mitral regurgitation between 1991 and 2010. Preoperative TR was classed as mild, trivial or absent in 479 (73.2%) patients, moderate in 125 (19.1%) patients and severe in 50 (7.7%) patients. Concomitant TV annuloplasty was performed in 162 patients (24.8%). The mean follow up duration was 7.5±4.9 years. Postoperative transthoracic echocardiography was performed according to a fixed schedule. The long-term survival rate and freedom from re-admission for congestive heart failure were affected by the severity of TR. Although the durability of ring annuloplasty was excellent up to 10 years after surgery, the mean TR grade started to increase after 10 years. Sixteen out of 492 patients who did not undergo TV annuloplasty (3.2%) revealed progression to severe TR. Preoperative atrial fibrillation (odds ratio (OR), 4.85; 95% confidence interval (CI), 1.38–17.1; P=0.014) and preoperative TR grade (OR, 5.16; 95% CI, 1.78–14.9; P=0.003) were predictors for progression to severe TR. Conclusions: ?Aggressive treatment with concomitant TV annuloplasty should be advocated in cases with atrial fibrillation and more than moderate TR.??( Circ J ?2013; 77: 2288–2294)
机译：背景：二尖瓣手术时是否应修复三尖瓣返流（TR）的问题一直存在争议，三尖瓣（TV）瓣环成形术的长期耐用性仍然未知。方法和结果：我们回顾性分析了1991年至2010年间因变性二尖瓣关闭不全而接受二尖瓣修复的654例患者。术前TR被分类为轻度，琐碎或无轻度患者479（73.2％），中度患者125（19.1％） 50例（7.7％）患者中严重。 162例患者（24.8％）同时进行了电视瓣环成形术。平均随访时间为7.5±4。9年。术后经胸超声心动图检查按照固定的时间表进行。 TR的严重程度会影响充血性心力衰竭的长期生存率和重新入院。尽管环形瓣环成形术的耐用性在手术后长达10年是极好的，但平均TR等级在10年后开始增加。 492例未进行电视瓣环成形术的患者中有16例（3.2％）表现为严重TR。术前房颤（几率（OR），4.85; 95％置信区间（CI），1.38-17.1; P = 0.014）和术前TR分级（OR，5.16; 95％CI，1.78-14.9; P = 0.003）为预测严重TR的进展。结论：对于房颤和中度以上TR的病例，应提倡积极进行伴有电视瓣环成形术的治疗。（Circ J？2013; 77：2288-2294）

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