摘要
左心瓣膜术后远期可发生三尖瓣反流。左心瓣膜术后单纯三尖瓣反流是指在二尖瓣和/或主动脉瓣置换或成形术后远期出现单纯三尖瓣反流,而左心瓣膜不存在需要再次干预的显著病变。由于严重的三尖瓣反流影响患者的长期预后,因此需要再次外科或介入手术治疗。然而,目前瓣膜指南中对于左心瓣膜术后单纯三尖瓣反流再次行三尖瓣手术干预的时机和方式尚无明确建议。当前多种微创外科技术和介入治疗的应用可能降低了三尖瓣手术的病死率。为进一步加深对左心瓣膜术后单纯三尖瓣反流的理解、规范治疗、改善预后、促进协作,国家心血管病专家委员会微创心血管外科专业委员会牵头从发病机制、术前评估、手术干预指证、外科手术、介入手术、围手术期管理等方面撰写了本专家共识。
Tricuspid regurgitation(TR)may occur late after left-sided valve surgery(LSVS).Isolated tricuspid regurgitation after left-sided valve surgery(iTR-LSVS)refers to isolated TR without significant lesions in the mitral and/or aortic position late after mitral and/or aortic replacement or repair.Severe TR has a negative impact on long-term prognosis and requires surgical or transcatheter treatment.However,there is no clear recommendation on when and how intervention should be performed for patients with iTR-LSVS in the current guidelines for the management of valvular heart disease.The historically high operative mortality may be reduced by current minimally invasive techniques and transcatheter therapy.To further understand iTR-LSVS,standardize the treatment,improve the prognosis,and promote the collaboration,the Chinese Minimally Invasive Cardiovascular Surgery Committee(CMICS)wrote this expert consensus on the management of iTR-LSVS from the aspects of etiology,preoperative evaluation,indications for intervention,surgical treatment,transcatheter therapy,and postoperative management.
出处
《中华胸心血管外科杂志》
CSCD
北大核心
2023年第5期265-272,共8页
Chinese Journal of Thoracic and Cardiovascular Surgery