Feasibility Study of Mitral Valve Surgery Combined with Tricuspid Valve Repair in Elderly Patients with Degenerative Mitral Valve Insufficiency Complicated with Low,Moderate Tricuspid Regurgitation and Annular Dilation
Objective:To investigate the effect of mitral valve replacement and tricuspid valvuloplasty in elderly patients with degenerative mitral insufficiency complicated with low,moderate regurgitation and annular dilation.Methods:Retrospective analysis was performed on 95 elderly patients with degenerative mitral valve insufficiency combined with low,moderate regurgitation of tricuspid valve with annular dilatation.Forty-seven patients were treated with mitral valve replacement(MVR)only as the control group,while 48 patients who underwent tricuspid valvuloplasty(TVP)surgery during the same period of MVP were treated as the study group.The surgical process and postoperative recovery indexes,preoperative and postoperative echocardiographic indexes,tricuspid regurgitation grade,and complication rate were compared between the two groups.Results:Operation time,aortic block time and cardiopulmonary bypass time in the study group were significantly longer than those in the control group,with statistical significance(P＜0.05).There were no significant differences in ICU stay time,pericardial mediastinal drainage and ventilator use time between the two groups(P＞0.05).At 24 months after surgery,the measured values of right atrial diameter(RA),right ventricular end-diastolic diameter(RVEDD),tricuspid valve diastolic annular diameter(DTV),and arterial hypertension(SPAP)in two groups were significantly lower than those before surgery(P＜0.05),and left ventricular short axis shortening rate(LVFS)in two groups were significantly higher than those before surgery(P＜0.05).RA,RVEDD,DTV,and SPAP in the study group were significantly lower than those in the control group,and LVFS were significantly higher than those in the control group,with statistical significance(P＜0.05).After 24 months of operation,there were 23 cases with no regurgitation,25 cases with mild regurgitation in the study group,4 cases with no regurgitation,14 cases with mild regurgitation and 29 cases with moderate regurgitation in the control group.The disease of tricuspid valve regurgitation in the study group was significantly reduced after surgery(P＜0.05).There was no significant difference in postoperative complications between the two groups(P＞0.05).Conclusion:ln elderly patients with degenerative mitral valve insufficiency combined with moderate,low tricuspid regurgitation and annular dilation,mitral valve replacement with concurrent tricuspid valve plasty can achieve better results than mitral valve replacement alone,and does not increase the incidence of surgical complications.
万方数据
维普
