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首页> 外文期刊>Journal of cardiac surgery. >Concomitant tricuspid valve repair or replacement during left ventricular assist device implant demonstrates comparable outcomes in the long term
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Concomitant tricuspid valve repair or replacement during left ventricular assist device implant demonstrates comparable outcomes in the long term

机译：长期以来，左心辅助设备植入过程中伴随的三尖瓣修复或置换显示出可比的结果

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Introduction: Severe tricuspid regurgitation (TR) is present in nearly half the patients undergoing implant of a left ventricular assist device (LVAD) and its correction confers better long-term outcome. Aim: To compare the early and late results of tricuspid valve repair (TVrpr) or replacement (TVR) with LVAD implant. Patient and Methods: Sixty-four from a cohort of 126 patients had a concomitant tricuspid valve procedure; 48 (75%) underwent a TVrpr whereas 16 (25%) had TVR. All preoperative hemodynamic parameters including the mean TR grade (TVrpr; 3.6 vs. TVR; 3.7) were comparable (p = 0.7). The mean TR grade was 1.6 ± 1.5 for the remaining 62 patients who did not have a concomitant tricuspid valve procedure, with 4/62 (6%) having severe TR (p < 0.0001). Results: Cardiopulmonary bypass time was longer for patients undergoing TVR (p = 0.01). There was a significant reduction in right atrial pressure for the entire cohort (p < 0.01) and the postoperative right atrial pressure was not statistically different between TVrpr (13.6 ± 4.6) and TVR (11.6 ± 4.3; p = 0.6. Postoperative intensive care unit stay was comparable as was the duration of inotropic support (p = 0.5) or need for temporary right ventricular mechanical support. In-hospital mortality (12%) was not different between groups. The mean time for LVAD support was 12.3 ± 9.71 months and the last transthoracic echocardiographic examination was performed at mean intervals of 13.8 ± 10.8 months (TVrpr) and 11.8 ± 7.6 months (TVR; p = 0.47). Reduction in TR grade was similar between groups (p = 0.27). Late mortality (p = 1.00) was comparable in both groups. Using log-rank analysis, there was no significant difference in the estimated survival between TVrpr and TVR (p = 0.88). Conclusion: TVrpr repair at the time of LVAD implant is effective in correcting TR even at the end of one year of follow-up. The choice to repair or replace does not affect the clinical outcome.
机译：简介：接受左心室辅助装置（LVAD）植入的患者中有近一半存在严重的三尖瓣关闭不全（TR），其矫正可带来更好的长期预后。目的：比较三尖瓣修复（TVrpr）或用LVAD植入物替代（TVR）的早期和晚期结果。患者和方法：126例患者中有64例同时进行了三尖瓣手术。 48（75％）接受了TVrpr，而16（25％）接受了TVR。所有术前血流动力学参数，包括平均TR级（TVrpr; 3.6 vs. TVR; 3.7）都是可比的（p = 0.7）。其余62例未同时进行三尖瓣手术的患者的平均TR等级为1.6±1.5，其中4/62（6％）的患者具有严重的TR（p <0.0001）。结果：接受TVR的患者的心肺旁路时间更长（p = 0.01）。整个队列的右房压显着降低（p <0.01），TVrpr（13.6±4.6）和TVR（11.6±4.3; p = 0.6。）术后重症监护室无统计学差异。住院时间与正性肌力支持的持续时间（p = 0.5）或需要临时右心室机械支持的时间相当，两组之间的院内死亡率（12％）相同，LVAD支持的平均时间为12.3±9.71个月，最后一次经胸超声心动图检查的平均间隔为13.8±10.8个月（TVrpr）和11.8±7.6个月（TVR; p = 0.47），两组之间的TR等级降低相似（p = 0.27）。 1.00）在两组中具有可比性。使用对数秩分析，TVrpr和TVR之间的估计生存率无显着差异（p = 0.88）结论：LVAD植入时TVrpr修复即使在术中也能有效校正TR。恩一年的随访时间。修理或更换的选择不影响临床结果。

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