目的:评估退行性二尖瓣(MV)修复的长期结果。
方法:本研究分析了2010年1月至2019年12月在北京安贞医院因退行性MV疾病行MV修复的1,069例患者。所有患者均在临床上随访至2019年12月,平均随访期为4.7年。围手术期并发症,30天死亡率,长期结果,总结了全因死亡和复发性二尖瓣返流(MR)的危险因素。
结果:10例患者在医院死亡,33例在随访期间死亡。113例患者发生复发MR。14例患者接受了再次手术。长期生存率,没有复发性MR,无再次手术者占94.0%(91.6%-96.6%),81.2%(77.3%-85.3%),和98.2%(97.2%-99.3%),分别。长期全因死亡的危险因素包括年龄和射血分数(EF)<60%。复发MR的危险因素包括年龄,女性性别,E波速度,前脱垂,术后残余1+MR,和较低的体重指数。
结论:二尖瓣修复术是治疗退行性MV疾病的有效方法,在一个有经验的心脏中心,可以以低死亡率进行,复发,和再操作率。高龄和EF<60%是长期全因死亡的危险因素。年龄,女性性别,术后残余1+MR,较低的体重指数,较高的峰值E波速度,前脱垂是MR复发的危险因素。
OBJECTIVE: To evaluate the long-term outcomes of degenerative mitral valve (MV) repair.
METHODS: This study analysed 1,069 patients who underwent MV repair due to degenerative MV disease at Beijing Anzhen Hospital from January 2010 to December 2019. All patients were clinically followed until December 2019, with an average follow-up period of 4.7 years. Perioperative complications, 30-day mortality, long-term outcomes, and risk factors of all-cause death and recurrent mitral regurgitation (MR) were summarised.
RESULTS: Ten patients died in the hospital and 33 died during the follow-up period. Recurrent MR occurred in 113 patients. Fourteen patients underwent re-operation. Rates of long-term survival, absence of recurrent MR, and no re-operation were 94.0% (91.6%-96.6%), 81.2% (77.3%-85.3%), and 98.2% (97.2%-99.3%), respectively. The risk factors for long-term all-cause death included age and an ejection fraction (EF) <60%. The risk factors for recurrent MR included age, female sex, E-wave velocity, anterior
prolapse, residual 1+MR postoperatively, and lower body mass index.
CONCLUSIONS: Mitral valve repair is an effective treatment for degenerative MV disease that, in an experienced heart centre, can be performed with low mortality, recurrence, and re-operation rates. Advanced age and an EF <60% were risk factors for long-term all-cause death. Age, female sex, residual 1+MR postoperatively, lower body mass index, higher peak E-wave velocity, and anterior
prolapse were risk factors for recurrent MR.