左心瓣膜术后再次三尖瓣病变手术方式的选择

The procedure choice for the reoperation of tricuspid valve lesion after left heart valve surgery

左心瓣膜术后三尖瓣关闭不全并不少见,多数治疗时间较晚,右心功能多逐渐恶化,全身状况较差,多合并肝肾功能不全及造血功能低下,其二次手术的策略选择及围手术期管理仍是当代心脏外科医师面临的重大挑战.本文介绍了这类患者的临床特点及手术时机,重点探讨了手术入路及三尖瓣手术术式的选择对手术结局的影响.

Tricuspid insufficiency late after left-sided heart valve surgery is not uncommon.These patients usually suffer from severe right heart insufficiency and poor general condition due to untimely surgical intervention,and are often complicated with hepatic and renal insufficiency and hemopoietic dysfunction.The choice of strategy for reoperation and perioperative management are still the major challenges for contemporary cardiac surgeons.This article introduces the clinical characteristics and operation timing of patients with severe tricuspid insufficiency after previous left-sided heart valve surgery,and focuses on the selection of operation approach and operation methods.