PMID- 17336080
OWN - NLM
STAT- MEDLINE
DCOM- 20070719
LR  - 20070409
IS  - 1010-7940 (Print)
IS  - 1010-7940 (Linking)
VI  - 31
IP  - 5
DP  - 2007 May
TI  - Primary triple valve surgery for advanced rheumatic heart disease in Mainland 
      China: a single-center experience with 871 clinical cases.
PG  - 845-50
AB  - BACKGROUND: Triple valve surgery (TVS) is still of choice for advanced rheumatic 
      heart disease (RHD), which has been associated with reported poor early and late 
      outcomes. We describe the short- and long-term results after TVS in last two 
      decades in Mainland China. METHODS: From January 1985 to January 2005, a total of 
      871 patients (217 men, 654 women), with mean age of 42+/-11 years, underwent 
      primary TVS for isolated advanced RHD. All patients received replacement 
      procedures in mitral and aortic position (845 mechanical, 26 bioprosthetic), and 
      840 patients received repair procedures and the other 31 received replacement 
      procedures in tricuspid position (9 mechanical, 22 bioprosthetic). Preoperative, 
      perioperative, and postoperative data were retrospectively analyzed and risk 
      factors affecting early and late survival were evaluated. RESULTS: The 30-day 
      hospital mortality was 8% (n=71). Presence of ascites, New York Heart Association 
      (NYHA) class IV and lower left ventricular ejection fraction (LVEF) were 
      identified as independent risk factors for hospital mortality. Overall long-term 
      survival rate was 71%+/-3% at 5 years, and 59%+/-5% at 10 years. The cardiac 
      survival rate was 75%+/-3% at 5 years and 63%+/-4% at 10 years. The event-free 
      survival rate at 5 years and 10 years was 61%+/-6% and 41%+/-13%, respectively. 
      Multivariate analysis revealed advanced age, NYHA class IV and lower LVEF were 
      associated with increased late mortality. The freedom from thromboembolism and 
      anticoagulation-related hemorrhage at 10 years was 90%+/-4% and 81%+/-5%, 
      respectively. Of the 508 patients still alive, 376 (74%) were in NYHA class I and 
      II. CONCLUSIONS: Primary TVS for advanced RHD appears to offer satisfactory 
      short- and long-term results with excellent symptomatic improvement. 
      Cardiac-related late mortality following TVS may be improved by early surgical 
      treatment before NYHA class IV or deterioration of LVEF occurs.
FAU - Han, Qing-Qi
AU  - Han QQ
AD  - Department of Cardiothoracic Surgery, Changhai Hospital, Second Military Medical 
      University, Shanghai, People's Republic of China.
FAU - Xu, Zhi-Yun
AU  - Xu ZY
FAU - Zhang, Bao-Ren
AU  - Zhang BR
FAU - Zou, Liang-Jian
AU  - Zou LJ
FAU - Hao, Jia-Hua
AU  - Hao JH
FAU - Huang, Sheng-Dong
AU  - Huang SD
LA  - eng
PT  - Journal Article
DEP - 20070301
PL  - Germany
TA  - Eur J Cardiothorac Surg
JT  - European journal of cardio-thoracic surgery : official journal of the European 
      Association for Cardio-thoracic Surgery
JID - 8804069
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aortic Valve/surgery
MH  - Bioprosthesis
MH  - Cardiac Surgical Procedures/methods
MH  - Cause of Death
MH  - China/epidemiology
MH  - Female
MH  - Heart Valve Prosthesis Implantation/methods
MH  - Heart Valves/*surgery
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Mitral Valve/surgery
MH  - Postoperative Complications
MH  - Reoperation
MH  - Retrospective Studies
MH  - Rheumatic Heart Disease/mortality/physiopathology/*surgery
MH  - Survival Analysis
MH  - Treatment Outcome
MH  - Tricuspid Valve/surgery
MH  - Ventricular Dysfunction, Left/mortality
EDAT- 2007/03/06 09:00
MHDA- 2007/07/20 09:00
CRDT- 2007/03/06 09:00
PHST- 2006/12/05 00:00 [received]
PHST- 2007/01/28 00:00 [revised]
PHST- 2007/02/02 00:00 [accepted]
PHST- 2007/03/06 09:00 [pubmed]
PHST- 2007/07/20 09:00 [medline]
PHST- 2007/03/06 09:00 [entrez]
AID - S1010-7940(07)00155-8 [pii]
AID - 10.1016/j.ejcts.2007.02.005 [doi]
PST - ppublish
SO  - Eur J Cardiothorac Surg. 2007 May;31(5):845-50. doi: 10.1016/j.ejcts.2007.02.005. 
      Epub 2007 Mar 1.