目的探討以人工血管環(huán)代替成形環(huán)治療三尖瓣關閉不全的臨床效果。方法回顧性分析第二軍醫(yī)大學長海醫(yī)院 2000年 7月至 2010年 7月收治三尖瓣關閉不全 56例患者的臨床資料,其中男 24例,女 32例;年齡 14~ 73(45.7±21.8)歲;均經(jīng)心臟彩色多普勒超聲心動圖明確診斷為三尖瓣中度至大量反流(瞬時反流量> 6 ml),其中風濕性心臟瓣膜病 47例,先天性心臟病三尖瓣下移畸形 9例。均采用人工血管環(huán)代替成形環(huán)治療三尖瓣關閉不全。結果全組患者無早期死亡。術后 1個月心臟超聲心動圖提示無三尖瓣關閉不全或輕度關閉不全,發(fā)生并發(fā)癥 3例,其中術后呼吸功能衰竭 1例,腎功能不全 1例,開胸止血 1例。遠期隨訪 48例,平均隨訪 3.8(1.0~ 9.5) 年,無晚期死亡,發(fā)生抗凝并發(fā)癥(腦梗死) 1例;心功能分級( NYHA):Ⅰ級 16例,Ⅱ級 26例,Ⅲ級 6例。隨訪期間超聲心動圖檢查提示:三尖瓣無關閉不全 36例,輕度關閉不全 10例,中度關閉不全 2例,無嚴重并發(fā)癥。結論人工血管環(huán)代替成形環(huán)治療三尖瓣關閉不全可以取得較滿意的早期和中期的臨床療效,可作為治療三尖瓣關閉不全的手術方法之一。
引用本文: 鄒良建,唐昊,郎希龍等. 人工血管環(huán)代成形環(huán)治療三尖瓣關閉不全56例. 中國胸心血管外科臨床雜志, 2012, 19(2): 151-153. doi: 復制
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2. | Anyanwu AC, Chikwe J, Adams DH.Tricuspid valve repair for treatment and prevention of secondary tricuspid regurgitation in patients undergoing mitral valve surgery.Curr Cardiol Rep, 2008, 10(2):110-117. |
3. | 陳和忠, 鄒良建, 徐志云, 等.三尖瓣硬質人工瓣環(huán)成形術的中期效果評價.中國胸心血管外科臨床雜志, 2005, 12(2):116-117. |
4. | Dreyfus GD, Corbi PJ, Chan KM, et a1.Secondary tricuspid regurgitation or dilatation:which should be the criteria for surgical repair? Ann Thorac Surg, 2005, 79(1):127-132. |
5. | Calafiore AM, Iaco AL, Romeo A, et a1.Echocardiographic-based treatment of functional tricuspid regurgitation.J Thorac Cardiovasc Surg, 2011, 142(2):308-313. |
6. | Chang BC, Song SW, Lee S, et a1.Eight-year outcomes of tricuspid annuloplasty using autologous pericardial strip for functional tricuspid regurgitation.Ann Thorac Surg, 2008, 86(5):1485-1492. |
7. | Antunes MJ, Barlow JB.Management of tricuspid valve regurgitation.Heart, 2007, 93(2):271-276. |
8. | Al-Ebrahim KE.Tricuspid valve replacement is an unfavourable operation. Eur J Cardiothorac Surg, 2010, 38(1):115-115. |
9. | Filsoufi F, Salzberg SP, Abascal V, et a1.Surgical management of functional tricuspid regurgitation with a new remodeling annuloplasty ring.Mt Sinai J Med, 2006, 73(6):874-879. |
10. | Al-Ebrahim K, Al Alassal A.Autologous pericardial strip repair of the tricuspid valve.Ann Thorac Surg, 2010, 89(2):674. |
11. | Myers PO, Christenson JT, Cikirikcioglu M, et a1.Leaflet suspension to the contralateral annulus to address restriction or tethering-induced mitral and tricuspid regurgitation in children: results of a case-control study.J Thorac Cardiovasc Surg, 2010, 140(5):1110-1116. |
12. | Kuwaki K, Morishita K, Tsukamoto M, et a1.Tricuspid valve surgery for functional tricuspid valve regurgitation associated with left-sided valvular disease.Eur J Cardiothorac Surg, 2001, 20(3):577-582. |
13. | 王建華, 李少輝, 尤斌, 等. 自體心包條環(huán)縮行三尖瓣成形術46例 . 中國胸心血管外科臨床雜志, 2006, 13(5):368. |
- 1. Ghoreishi M, Brown JM, Stauffer CE, et a1.Undersized tricuspid annuloplasty rings optimally treat functional tricuspid regurgitation. Ann Thorac Surg, 2011, 92(1):89-95.
- 2. Anyanwu AC, Chikwe J, Adams DH.Tricuspid valve repair for treatment and prevention of secondary tricuspid regurgitation in patients undergoing mitral valve surgery.Curr Cardiol Rep, 2008, 10(2):110-117.
- 3. 陳和忠, 鄒良建, 徐志云, 等.三尖瓣硬質人工瓣環(huán)成形術的中期效果評價.中國胸心血管外科臨床雜志, 2005, 12(2):116-117.
- 4. Dreyfus GD, Corbi PJ, Chan KM, et a1.Secondary tricuspid regurgitation or dilatation:which should be the criteria for surgical repair? Ann Thorac Surg, 2005, 79(1):127-132.
- 5. Calafiore AM, Iaco AL, Romeo A, et a1.Echocardiographic-based treatment of functional tricuspid regurgitation.J Thorac Cardiovasc Surg, 2011, 142(2):308-313.
- 6. Chang BC, Song SW, Lee S, et a1.Eight-year outcomes of tricuspid annuloplasty using autologous pericardial strip for functional tricuspid regurgitation.Ann Thorac Surg, 2008, 86(5):1485-1492.
- 7. Antunes MJ, Barlow JB.Management of tricuspid valve regurgitation.Heart, 2007, 93(2):271-276.
- 8. Al-Ebrahim KE.Tricuspid valve replacement is an unfavourable operation. Eur J Cardiothorac Surg, 2010, 38(1):115-115.
- 9. Filsoufi F, Salzberg SP, Abascal V, et a1.Surgical management of functional tricuspid regurgitation with a new remodeling annuloplasty ring.Mt Sinai J Med, 2006, 73(6):874-879.
- 10. Al-Ebrahim K, Al Alassal A.Autologous pericardial strip repair of the tricuspid valve.Ann Thorac Surg, 2010, 89(2):674.
- 11. Myers PO, Christenson JT, Cikirikcioglu M, et a1.Leaflet suspension to the contralateral annulus to address restriction or tethering-induced mitral and tricuspid regurgitation in children: results of a case-control study.J Thorac Cardiovasc Surg, 2010, 140(5):1110-1116.
- 12. Kuwaki K, Morishita K, Tsukamoto M, et a1.Tricuspid valve surgery for functional tricuspid valve regurgitation associated with left-sided valvular disease.Eur J Cardiothorac Surg, 2001, 20(3):577-582.
- 13. 王建華, 李少輝, 尤斌, 等. 自體心包條環(huán)縮行三尖瓣成形術46例 . 中國胸心血管外科臨床雜志, 2006, 13(5):368.