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Abstract：
UNASSIGNED: The choice to operate on moderate tricuspid regurgitation (TR) during mitral surgery is challenging owing to limited mid-term data. We assess whether concomitant tricuspid operations improve mid-term quality of life, morbidity, or mortality.
UNASSIGNED: An institutional database identified mitral surgery recipients with moderate TR at the time of surgery from 2010 to 2019. Patients were stratified by the presence of a concomitant tricuspid operation. Quality of life at the last follow-up was assessed with the Kansas City Cardiomyopathy Questionnaire (KCCQ-12). Morbidity was compared using the χ2 test, Mann-Whitney U test, and Student t test. Survival was analyzed with Kaplan-Meier estimation.
UNASSIGNED: Of 210 mitral surgery recipients, 67 (31.9%) underwent concomitant tricuspid surgery. The concomitant tricuspid surgery cohort had greater preoperative dialysis use (10.5% vs 3.5%; P = .043) but similar age, New York Heart Association class, and cardiac surgery history relative to the nonconcomitant cohort (P > .05 for all). The concomitant tricuspid surgery cohort had a longer cardiopulmonary bypass time (144 minutes vs 122 minutes; P = .005) but a similar rate of mitral repair (P = .220). Postoperative KCCQ-12 scores reflected high quality of life in both cohorts (95.1 vs 89.1; P = .167). The concomitant tricuspid surgery cohort trended toward a higher perioperative pacemaker placement rate (22.8% vs 12.7%; P = .088) but were less likely to develop severe TR (0.0% vs 13.0%; P = .004). Overall survival was comparable between the 2 cohorts at 1 year (84.9% vs 81.6%; P = .628) and 5 years (73.5% vs 57.9%; P = .078). Five-year survival free from severe TR was higher in the concomitant cohort (73.5% vs 54.3%; P = .032).
UNASSIGNED: Concomitant tricuspid surgery for moderate TR is associated with increased 5-year survival free from severe TR but not with increased quality of life.
UNASSIGNED: An institutional database identified mitral surgery recipients with moderate TR at the time of surgery from 2010 to 2019. Patients were stratified by the presence of a concomitant tricuspid operation. Quality of life at the last follow-up was assessed with the Kansas City Cardiomyopathy Questionnaire (KCCQ-12). Morbidity was compared using the χ2 test, Mann-Whitney U test, and Student t test. Survival was analyzed with Kaplan-Meier estimation.
UNASSIGNED: Of 210 mitral surgery recipients, 67 (31.9%) underwent concomitant tricuspid surgery. The concomitant tricuspid surgery cohort had greater preoperative dialysis use (10.5% vs 3.5%; P = .043) but similar age, New York Heart Association class, and cardiac surgery history relative to the nonconcomitant cohort (P > .05 for all). The concomitant tricuspid surgery cohort had a longer cardiopulmonary bypass time (144 minutes vs 122 minutes; P = .005) but a similar rate of mitral repair (P = .220). Postoperative KCCQ-12 scores reflected high quality of life in both cohorts (95.1 vs 89.1; P = .167). The concomitant tricuspid surgery cohort trended toward a higher perioperative pacemaker placement rate (22.8% vs 12.7%; P = .088) but were less likely to develop severe TR (0.0% vs 13.0%; P = .004). Overall survival was comparable between the 2 cohorts at 1 year (84.9% vs 81.6%; P = .628) and 5 years (73.5% vs 57.9%; P = .078). Five-year survival free from severe TR was higher in the concomitant cohort (73.5% vs 54.3%; P = .032).
UNASSIGNED: Concomitant tricuspid surgery for moderate TR is associated with increased 5-year survival free from severe TR but not with increased quality of life.
摘要：
■由于中期数据有限，在二尖瓣手术期间对中度三尖瓣反流（TR）进行手术的选择具有挑战性。我们评估是否伴随三尖瓣手术改善中期生活质量，发病率，或死亡率。
■一个机构数据库确定了2010年至2019年手术时具有中度TR的二尖瓣手术接受者。通过同时进行三尖瓣手术对患者进行分层。使用堪萨斯城心肌病问卷（KCCQ-12）评估最后一次随访时的生活质量。发病率比较采用χ2检验，Mann-WhitneyU测试,学生t检验。用Kaplan-Meier估计分析生存率。
■在210名二尖瓣手术受者中，67例（31.9％）同时接受了三尖瓣手术。伴随三尖瓣手术队列的术前透析使用率较高（10.5％vs3.5％；P=0.043），但年龄相似，纽约心脏协会班,和心脏手术史相对于非合并队列（P>0.05）。伴随三尖瓣手术队列的体外循环时间更长（144分钟比122分钟；P=0.005），但二尖瓣修复率相似（P=0.220）。术后KCCQ-12评分反映了两组患者的生活质量较高（95.1vs89.1；P=.167）。伴随的三尖瓣手术队列倾向于更高的围手术期起搏器放置率（22.8%vs12.7%；P=0.088），但发生严重TR的可能性较小（0.0%vs13.0%；P=0.004）。在1年（84.9%vs81.6%;P=.628）和5年（73.5%vs57.9%;P=.078）时，两组患者的总生存率相当。伴随队列中无严重TR的5年生存率较高（73.5%vs54.3%；P=0.032）。
■中度TR伴随三尖瓣手术与无重度TR的5年生存率增加相关，但与生活质量增加无关。
■一个机构数据库确定了2010年至2019年手术时具有中度TR的二尖瓣手术接受者。通过同时进行三尖瓣手术对患者进行分层。使用堪萨斯城心肌病问卷（KCCQ-12）评估最后一次随访时的生活质量。发病率比较采用χ2检验，Mann-WhitneyU测试,学生t检验。用Kaplan-Meier估计分析生存率。
■在210名二尖瓣手术受者中，67例（31.9％）同时接受了三尖瓣手术。伴随三尖瓣手术队列的术前透析使用率较高（10.5％vs3.5％；P=0.043），但年龄相似，纽约心脏协会班,和心脏手术史相对于非合并队列（P>0.05）。伴随三尖瓣手术队列的体外循环时间更长（144分钟比122分钟；P=0.005），但二尖瓣修复率相似（P=0.220）。术后KCCQ-12评分反映了两组患者的生活质量较高（95.1vs89.1；P=.167）。伴随的三尖瓣手术队列倾向于更高的围手术期起搏器放置率（22.8%vs12.7%；P=0.088），但发生严重TR的可能性较小（0.0%vs13.0%；P=0.004）。在1年（84.9%vs81.6%;P=.628）和5年（73.5%vs57.9%;P=.078）时，两组患者的总生存率相当。伴随队列中无严重TR的5年生存率较高（73.5%vs54.3%；P=0.032）。
■中度TR伴随三尖瓣手术与无重度TR的5年生存率增加相关，但与生活质量增加无关。
