低侵襲僧帽弁形成術の進化：高件数センターにおける30年間の経験
Jagdip Kang1, Mateo Marin-Cuartas1, Philipp Kiefer1
1University Department of Cardiac Surgery, Leipzig Heart Center, Leipzig, Germany.
Annals of thoracic surgery short reports
|December 22, 2025
まとめ
低侵襲僧帽弁形成術（MVr）の予後は、数十年にわたり著しく改善している。単独のMVrおよび併用三尖弁（TV）手術の両方で長期生存率が向上しており、本手技の有効性を示している。
科学分野:
- 心臓血管外科; 低侵襲心臓手術; 弁膜疾患
背景:
- 低侵襲僧帽弁形成術（MVr）は標準的な手技であり、しばしば三尖弁（TV）手術と組み合わせて行われます。; これらの複合手技の長期予後とその経時的な変遷に関するエビデンスは限られています。; 本研究では、数十年間にわたる単独または同時のTV手術を伴う低侵襲MVrの予後改善を調査します。
研究 の 目的:
- 低侵襲僧帽弁形成術（MVr）後の長期生存率の推移を評価すること。; 単独または同時に三尖弁（TV）手術を受けた低侵襲MVrの予後の変遷を評価すること。; 手術成績が異なる期間を通じて改善したかどうかを判断すること。
主な方法:
- 1996年から2023年の間に低侵襲MVrを受けた5559人の患者の後ろ向き解析。; 患者は1996-2001年から2020-2023年までの5つの手術期間に分類されました。; 主要評価項目は10年生存率であり、副次解析には同時のTV手術を受けた患者が含まれました。
主要な成果:
- 30日死亡率は1996-2001年の1.1%から2020-2023年の0.3%に減少しました。; 10年生存率は1996-2001年の68.1%から2014-2019年の83.7%に改善しました。; 同時のTV手術を受けた患者では、1年および10年生存率は期間を通じて著しく改善しました。
結論:
- 単独またはTV手術を伴う低侵襲MVrは、安全で再現可能なアプローチです。; 本手技は合併症率が低く、胸骨切開への移行はまれです。; 優れた早期および長期生存率が達成され、時間とともに改善しています。
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