Early and long-term outcomes after left-side heart valve replacement and tricuspid valve replacement in rheumatic patients
10.3760/cma.j.cn112434-20200927-00442
- VernacularTitle:风湿性联合瓣膜病行左心瓣膜置换同期机械瓣三尖瓣置换术后早期与远期临床结果分析
- Author:
Xiliang ZHU
1
;
Zhaoyun CHENG
;
Sheng WANG
;
Xianjie CHEN
;
Guoqing LU
Author Information
1. 阜外华中心血管病医院心血管外科，郑州 450000
- Keywords:
Rheumatic heart disease;
Tricuspid valve replacement;
Left side heart valve replacement;
Long-term survival rate
- From:
Chinese Journal of Thoracic and Cardiovascular Surgery
2022;38(6):327-331
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate and compare the early and long-term outcomes of rheumatic patients who underwent left-side heart valve replacement with concomitant tricuspid valve replacement, and analyze the difference of early mortality and long-term survival rate between mild pulmonary artery systolic pressure (PASP) and moderate to severe PASP patients.Methods:From January 2009 to December 2018, 79 cases of patients were reviewed and summarized. The mean age before operation was (45.7±7.8) years old. These patients were divided into mild PASP group(<50 mmHg, 38 cases) (1 mmHg=0.133 kPa) and moderate-severe PASP group (>50 mmHg, 41 cases) . Kaplan- Meier method was used to estimate the overall long-term survival rate and the incidence of complications, and to compare the long-term survival rate of patients with mild and moderate -severe PASP elevation. Results:The mortality rate of early postoperative patients was 8.9% (7/79). The causes of death included: low cardiac output syndrome in 3 cases, multiple organ failure caused by pulmonary infection in 2 cases, acute renal insufficiency in 1 case, sudden cardiac arrest in 1 case. Although the mortality rate of early moderate-severe PASP group (12.2% vs. 5.3%) was higher than that of mild PASP group, there was no significant difference ( P>0.05). The mean follow-up time was (51.8±31.7) months (3-115 months). Kaplan- Meier method was used to estimate the 10-year survival rate, the rate of avoiding thrombosis, the rate of avoiding serious bleeding event and the rate of avoiding reoperation, which were (67.2±10.6)%, (85.7±6.2)%, (83.4± 6.9)% and (93.7 ± 3.7)%, respectively. Although the long-term survival rate of mild PASP (78.0±10.6) % was higher than that of moderate-severe PASP (62.8 ± 13.4) %, there was no significant difference ( P>0.05). Conclusion:The early mortality rate of rheumatic patients who underwent left-side heart valve replacement with concomitant tricuspid valve replacement is still relatively high. The recurrent heart failure is the major causes of long-term death.
