Objective To observe early and intermediate-term clinical outcomes of tricuspid valvuloplasty withannuloplasty ring for the treatment of secondary tricuspid regurgitation （TR） of patients with rheumatic heart disease. MethodsFrom December 2009 to September 2011, 41 patients with rheumatic heart disease underwent left-side heart valve replacementand concomitant tricuspid valvuloplasty with annuloplasty ring in Sichuan Jianyang People’s Hospital. There were 12 males and 29 females with their mean age of 49 （21-67） years. Preoperatively, there were 38 patients with atrial fibrillation, 13 patients with left atrial thrombus; 2 patients with trivial TR, 5 patients with mild TR, 11 patients with moderate TR, and 23 patients with severe TR. Twenty-eight patients received mitral valve replacement and 13 patients received mitral and aortic valve replacement. All the patients were followed up every 3 months at the outpatient department, and received color Doppler echocardiography examination to observe TR degree at the 6th postoperative month. Results Postoperative heart function improved by 2-3 class in all the patients. There were 39 patients with New York Heart Association (NYHA) classⅠorⅡ postoperatively, and postoperative heart function was significantly better than preoperative heart function（P＜0.05）. All the patients were followed up for 6-27 months, and there was no death during follow-up. Color Doppler echocardiography at the 6th postoperative month showed that TR degrees were significantly decreased than preoperative TR degrees. There were 39 patients with trivial or mild TR during follow-up, which was significantly different with preoperativeTR degree （P＜0.05）. Right ventricle dimension decreased from preoperative 20 mm to 17 mm during follow-up, which were statistically different （P＜0.05）. Conclusion Early and intermediate-term clinical outcomes of tricuspid valvuloplasty with annuloplasty ring for the treatment of TR are satisfactory, while further evaluation for its long-term outcome is needed.
Citation：
LIU Yong,LIU Jian,HUANG Jixiu,LI Shiying,LIN Xiaobin,FU Jian.. Clinical Application of Annuloplasty Ring in Tricuspid Valvuloplasty for the Treatment of Tricuspid Regurgitation. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2013, 20(2): 152-154. doi: 10.7507/1007-4848.20130048
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Copyright © the editorial department of Chinese Journal of Clinical Thoracic and Cardiovascular Surgery of West China Medical Publisher. All rights reserved
| 1. |
Raja SG， Dreyfus GD. Basis for intervention on functional tricuspid regurgitation. Semin Thorac Cardiovasc Surg， 2010， 22 （1）：79-83.
|
| 2. |
汪永义， 薛松， 徐根兴， 等. 左心瓣膜手术后重度三尖瓣反流的外科治疗. 中国胸心血管外科临床杂志， 2011， 18 （4）：362-364.
|
| 3. |
肖锡俊， 袁宏声， 唐红， 等. 二尖瓣置换术后三尖瓣反流的逆转、残留或加重. 中国胸心血管外科临床杂志， 2006， 13 （5）：307-310.
|
| 4. |
周睿， 徐方杰， 陈佩莉， 等. 三尖瓣环成形治疗功能性三尖瓣反流245例总结. 中国循环杂志， 2009， 24 （1）：52-55.
|
| 5. |
Shiran A， Sagie A. Tricuspid regurgitation in mitral valve disease incidence， prognostic implications， mechanism， and management. J Am Coll Cardiol， 2009， 53 （5）：401-408.
|
| 6. |
朱晓东， 张宝仁， 主编. 心脏外科学. 北京：人民卫生出版社， 2007. 744-766.
|
| 7. |
李宗虓， 郭志鹏， 何国伟， 等. 二尖瓣置换术后三尖瓣关闭不全的外科治疗体会. 天津医药， 2010， 38 （10）：915-916.
|
| 8. |
Tang GH， David TE， Singh SK， et al. Tricuspid valve repair with an annuloplasty ring results in improved long-term outcomes.Circulation， 2006， 114 （1 Suppl）：I577-I581.
|
| 9. |
向波， 唐红， 周文霞， 等. 二尖瓣置换加三尖瓣成形术前后右房室径、房室环变化及临床意义. 四川大学学报：医学版， 2009， 40 （3）：490-494.
|
| 10. |
潘世伟， 胡盛寿. 继发性三尖瓣关闭不全的外科治疗进展. 中国胸心血管外科临床杂志， 2012， 19 （2）：185-188.
|
| 11. |
刘维永， 易定华， 主编. 现代心脏外科治疗学 .西安：世界图书出版公司， 2009. 809-810.
|
| 12. |
Bonow RO， Carabello BA， Chatterjee K， et al. 2008 focused update incorporated into the ACC/AHA 2006 guidelines for the management of patients with valvular heart disease：a report of the American Collegeof Cardiology/American Heart Association Task Force on Practice Guidelines （Writing Committee to revise the 1998 guidelines for the management of patients with valvular heart disease）. Endorsed by the Society of Cardiovascular Anesthesiologists， Society for Cardiovascular Angiography and Interventions， and Society of Thoracic Surgeons. J Am Coll Cardiol， 2008， 52 （13）：e1-142.
|
| 13. |
朱鹏， 肖锡俊， 唐红， 等. 以三尖瓣瓣环径作为三尖瓣成形手术指征的初步临床观察. 中国胸心血管外科临床杂志， 2008， 15 （4）：245-248.
|
| 14. |
Ghanta RK， Chen R， Narayanasamy N， et al. Suture bicuspidization of the tricuspid valve versus ring annuloplasty for repair of functional tricuspid regurgitation：midterm results of 237 consecutive patients. Thorac Cardiovasc Surg， 2007， 133 （1）：117-126.
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- 1. Raja SG， Dreyfus GD. Basis for intervention on functional tricuspid regurgitation. Semin Thorac Cardiovasc Surg， 2010， 22 （1）：79-83.
- 2. 汪永义， 薛松， 徐根兴， 等. 左心瓣膜手术后重度三尖瓣反流的外科治疗. 中国胸心血管外科临床杂志， 2011， 18 （4）：362-364.
- 3. 肖锡俊， 袁宏声， 唐红， 等. 二尖瓣置换术后三尖瓣反流的逆转、残留或加重. 中国胸心血管外科临床杂志， 2006， 13 （5）：307-310.
- 4. 周睿， 徐方杰， 陈佩莉， 等. 三尖瓣环成形治疗功能性三尖瓣反流245例总结. 中国循环杂志， 2009， 24 （1）：52-55.
- 5. Shiran A， Sagie A. Tricuspid regurgitation in mitral valve disease incidence， prognostic implications， mechanism， and management. J Am Coll Cardiol， 2009， 53 （5）：401-408.
- 6. 朱晓东， 张宝仁， 主编. 心脏外科学. 北京：人民卫生出版社， 2007. 744-766.
- 7. 李宗虓， 郭志鹏， 何国伟， 等. 二尖瓣置换术后三尖瓣关闭不全的外科治疗体会. 天津医药， 2010， 38 （10）：915-916.
- 8. Tang GH， David TE， Singh SK， et al. Tricuspid valve repair with an annuloplasty ring results in improved long-term outcomes.Circulation， 2006， 114 （1 Suppl）：I577-I581.
- 9. 向波， 唐红， 周文霞， 等. 二尖瓣置换加三尖瓣成形术前后右房室径、房室环变化及临床意义. 四川大学学报：医学版， 2009， 40 （3）：490-494.
- 10. 潘世伟， 胡盛寿. 继发性三尖瓣关闭不全的外科治疗进展. 中国胸心血管外科临床杂志， 2012， 19 （2）：185-188.
- 11. 刘维永， 易定华， 主编. 现代心脏外科治疗学 .西安：世界图书出版公司， 2009. 809-810.
- 12. Bonow RO， Carabello BA， Chatterjee K， et al. 2008 focused update incorporated into the ACC/AHA 2006 guidelines for the management of patients with valvular heart disease：a report of the American Collegeof Cardiology/American Heart Association Task Force on Practice Guidelines （Writing Committee to revise the 1998 guidelines for the management of patients with valvular heart disease）. Endorsed by the Society of Cardiovascular Anesthesiologists， Society for Cardiovascular Angiography and Interventions， and Society of Thoracic Surgeons. J Am Coll Cardiol， 2008， 52 （13）：e1-142.
- 13. 朱鹏， 肖锡俊， 唐红， 等. 以三尖瓣瓣环径作为三尖瓣成形手术指征的初步临床观察. 中国胸心血管外科临床杂志， 2008， 15 （4）：245-248.
- 14. Ghanta RK， Chen R， Narayanasamy N， et al. Suture bicuspidization of the tricuspid valve versus ring annuloplasty for repair of functional tricuspid regurgitation：midterm results of 237 consecutive patients. Thorac Cardiovasc Surg， 2007， 133 （1）：117-126.
