Evaluation of clinic effects after different tricuspid valvuloplasty in patients with secondary tricuspid valve insufficiency
Objectives Tricuspid valve(TV) insufficiency secondary to valvular heart disease or congenital heart disease is the most common aetiology of tricuspid regurgitation(TR). Appropriate treatment can improve long-term outcome. However, valve annuloplasty is the primary treatment for TV insufficiency. Our objective was to assess the short-term effectiveness of patients underwent tricuspid valve procedures for moderate or severe tricuspid regurgitation. These included De Vega suture tricuspid valve annuloplasty and ring annuloplasty. Methods A retrospective analysis of 65 consecutive patients with moderate to severe TR who underwent TV surgery between January 2010 and December 2012 with either a ring annuloplasty(Group Ring: n=35) or a De Vega suture annuloplasty (Group De Vega: n=30) at our hospital. The etiology for tricuspid regurgitation was rheumatic mitral and/or aortic valve diseases in 52 cases, adult atrial septal defect(ASD) in 13 cases. At different follow-up time point, the tricuspid regurgitation of all the patients was tested using ultrasound cardiography. The follow-up results were compared in 2 groups of patients. Results All patients survived from the operation. The follow up time was 0.5 to 2.6 years. The heart function improved to be NYHA class Ⅱ to Ⅲ in all patients. By 6 months after operation, right atrial diameter, right ventricle diameter and pulmonary artery systolic pressure in 2 groups was lower than the preoperative(P<0.05). However, by 2 years, pulmonary artery systolic pressure in ring group was still a downward trend(P<0.05). Echocardiography showed that trivial to mild TR was in all patients with ring annuloplasty after 6 months, and no moderate to severe TR war observed in one or two years later. By 0.5year, 1year and 2years follow up, echocardiography showed that trivial to mild TR was 83.3%, 94.5% and 88.9% respectively, and moderate TR was 16.7%, 4.5% and 11.1% respectively, but no severe TR cases in De Vega group. Conclusions In our experience, both De Vega annuloplasty suture and annuloplasty ring give satisfactory results, placement of an annuloplasty ring in patients undergoing tricuspid valve annuloplasty is significantly better than a De Vega's annuloplasty suture.The long-term effect still need further follow up.
NETL
NSTL
万方数据
维普
