自体心包三尖瓣成形术4例报告

对4例三尖瓣瓣叶发育不良、缺如或瓣叶、瓣下结构毁损患者行自体心包三尖瓣成形术.2例Eb-stein's畸形行新鲜自体心包片修复三尖瓣前瓣及腱索转移技术,同时准确测量三尖瓣隔瓣环长度(SL),按照1.75倍SL修剪经0.2%戊二醛处理的自体心包片用于精确环缩三尖瓣前瓣环及后瓣环,同期行继发孔房间隔缺损修补手术、"缘对缘"三尖瓣成形手术各1例.2例三尖瓣细菌性心内膜炎病变者采用病变瓣叶切除,新鲜自体心包片修复瓣叶及人工腱索技术;同期行"缘对缘"三尖瓣成形术1例.结果 无手术死亡;出院前心脏超声检查示三尖瓣启闭良好,无反流或残留微量反流;随访4～24个月,微至少量反流3例,少至中量反流1例.心包片替代的三尖瓣前叶活动尚好,无增厚,无钙化.证明三尖瓣器质性病变应用自体心包片行瓣环成形术、瓣叶成形术早期效果良好,远期效果有待观察.     

三维成形环治疗老年风湿性心脏瓣膜病继发性三尖瓣关闭不全的疗效

目的 比较三尖瓣人工瓣环成形术与缝线成形术对老年风湿性心脏瓣膜病三尖瓣关闭不全患者的成形效果.方法 选择分析2008年1月至2010年7月收治的69例老年风湿性心脏瓣膜病继发性三尖瓣关闭不全患者的临床资料.69例患者分为缝线成形组及人工瓣环组.两组间在术前三尖瓣反流程度、心功能分级(NYHA分级)、肺动脉压力等方面均无明显差异.观察和分析两组患者术前及术后的右心房内径(RAD)、右心室前后径(RVD)、三尖瓣反流面积、心排出量(C0).结果 两组病例均无手术死亡及住院死亡.两组患者组内术后1 w、术后6个月右心房内径、右心室前后径、三尖瓣反流面积较术前有统计学意义(P＜0.05);两组内心排出量术后6个月有统计学意义(P＜0.05);组间三尖瓣反流面积差别有统计学意义(P＜0.05);组间心排出量术后6个月有统计学意义(P＜0.05).术后6个月,缝线成形组出现4例(4/36)三尖瓣重度反流;人工瓣环组未出现三尖瓣重度反流.结论 缝线成形术和人工瓣环成形术均是治疗风湿性心脏瓣膜病继发性三尖瓣关闭不全的有效方法;三尖瓣人工瓣环成形术成形效果优于缝线成形术;左心瓣膜手术同期行三尖瓣成形术可明显增加术后中期心排出量,改善心功能.     

应用自体心包瓣膜成型

目的 探讨应用自体心包进行心脏二尖瓣、三尖瓣瓣膜成型的技术特点和可行性,评价其术后效果.方法 2005年1月至2006年6月我院采用自体心包成型心脏瓣膜6例,其中男性4例,女性2例.先天性心脏病室间隔缺损合并感染性心内膜炎致三尖瓣关闭不全2例,致二尖瓣关闭不全1例;黏液变性二尖瓣关闭不全3例.4例二尖瓣病变采用了双孔成形技术,同时用自体心包片制作成形环,替代人造瓣环或自体心包片修补后叶.2例三尖瓣病变用自体心包片修补三尖瓣前瓣叶以及隔瓣,瓣环再行De vaga环缩.结果 6例患者均顺利出院,随访3个月.术后患者二尖瓣、三尖瓣反流程度均有明显改善(P＜0.05),心功能均有明显提高(P＜0.05).结论 自体心包材料能最大限度地发挥瓣膜成型手术的优势,降低并发症和手术费用,近期效果良好.     

风湿性三尖瓣重度关闭不全外科治疗的疗效分析

目的 评价三尖瓣成形术和三尖瓣生物瓣置换术对治疗风湿性心脏瓣膜病三尖瓣重度关闭不全的临床疗效。方法 回顾性分析我院2014年1月至2016年12月37例风湿性心瓣膜病三尖瓣重度关闭不全患者的临床资料。按不同手术方式将患者分为2组：三尖瓣成形术组（成形组）23例和三尖瓣生物瓣置换术组（置换组）14例。术前两组患者的年龄、性别、心功能分级（NYHA）和三尖瓣返流分级等指标未见统计学差异（P＞0.05）。记录两组患者术前、术后及1年后随访的心功能分级、右心房横径、右心室舒张期末内径和三尖瓣返流面积。结果 术后早期死亡 3 例（均为置换组）,其中低心排2例、心律失常1例;其余患者均痊愈出院。中期随访各组生存率分别为：成形组23/23（100%）、置换组11/14（78.57%）;心功能分级分别为：成形组心功能Ⅰ级13例、Ⅱ级6例、Ⅲ级4例,置换组心功能Ⅱ级7例、Ⅲ级3例、Ⅳ级1例。中期随访各组生存率、心功能分级差异有统计学意义（P＜0.05）,成形组均优于置换组。中期随访三尖瓣返流分级分别为：成形组轻返流22例,中度返流1例,置换组轻度返流11例,差异无统计学意义（P＞0.05）。结论 三尖瓣生物瓣置换术后早期死亡率较高,患者心功能较差;三尖瓣成形术后中期返流程度与三尖瓣生物瓣置换术组相似,并且患者术后心功能良好、生存率较高,值得临床推广。     

Carpenter环三尖瓣成形术治疗左心瓣膜病合并的三尖瓣关闭不全

应用Carpenter环三尖瓣成形术治疗左心系统瓣膜病合并三尖瓣关闭不全25例.18例放置28号人工瓣环者出院时无1例出现三尖瓣少量以上反流,3例放置30#环者出院时出现三尖瓣少量以上反流1例,中量反流2例;3例放置32#瓣环者术后出现三尖瓣少量以上反流1例.认为采用成形环同期三尖瓣成形术治疗左心系统瓣膜病合并三尖瓣关闭不全患者的三尖瓣病变,安全有效.     

自体心包夹涤纶条在三尖瓣关闭不全成型术中的应用

目的:总结应用自体心包夹涤纶条的方法治疗重度三尖瓣关闭不全的经验.方法:2001-07至2007-10间67例重度三尖瓣关闭不全的患者术中全部应用自体心包夹涤纶条间断缝合将其固定于三尖瓣环上,根据瓣环扩大部位及程度决定该处缝缩多少.结果:手术后早期死亡1例.44例术后无三尖瓣反流或仅有极少量反流,16例术后轻度反流,7例为中度反流.随访3～72个月,平均46.5个月,随访期间,术后无反流的患者中有2例患者出现轻度反流,术后轻度反流的患者8例未出现反流,术后中度反流的患者4例变为轻度反流.1例患者术后3年死于脑出血.结论:自体心包夹涤纶条三尖瓣成型术是纠正重度三尖瓣关闭不全的有效方法.     

成形环治疗三尖瓣关闭不全的疗效及复发因素分析

目的总结应用成形环治疗功能性三尖瓣关闭不全(FTR)的治疗效果及术后复发危险因素分析。方法以简阳市人民医院心血管外科2012年10月至2015年12月在心脏瓣膜手术同期使用人工瓣环行三尖瓣成形术的124例患者为研究对象,进行单因素和多因素Logistic回归分析,找出影响三尖瓣成形术后复发三尖瓣反流(TR)的危险因素。结果全组患者随访2～5年,随访期末三尖瓣反流构成比明显改善,与术前比较差异有统计学意义(P0.05)。单因素分析显示,术前纽约心脏协会心功能分级(NYHA)3级、术前左心房前后径(LA)、术后右心房横径(RA)、术后右心室内径(RV)、合并心房颤动、瓣环类型、术前三尖瓣反流程度重、术后右心室缩短率与三尖瓣成形术后复发有关;经多因素Lgostic回归分析显示,术前左心房前后径60 mm、术前三尖瓣反流程度重、术后右心室缩短率是三尖瓣成形术后复发三尖瓣反流的独立危险因素。与传统的佰仁思硬环相比,MC3 Edwards成形环能更有效地减少术后三尖瓣反流的发生。结论三尖瓣成形术后三尖瓣反流的发生与患者术前左心房前后径60 mm、术前三尖瓣反流程度重、术后右心室缩短率、瓣环类型有关。应用硬质成形环行三尖瓣成形治疗功能性三尖瓣关闭不全,近中期疗效好。     

缘对缘瓣膜成形术在重度三尖瓣关闭不全治疗中的应用

目的观察缘对缘瓣膜成形术在重度三尖瓣关闭不全治疗中的应用效果。方法选择先天性心脏病继发重度三尖瓣关闭不全患者24例,先矫治其心内畸形,对三尖瓣瓣环成形不良者采用缘对缘瓣膜成形术。结果本组住院期间均无死亡病例,术后未出现并发症。出院时超声检查示,无或仅有微量的三尖瓣关闭不全20例,轻度反流4例;术后平均随访52.4个月,超声心动图检查示,无或仅有微量的三尖瓣关闭不全10例,轻度关闭不全12例,中度关闭不全2例,无三尖瓣狭窄。结论缘对缘瓣膜成形术用于重度三尖瓣关闭不全的治疗安全有效。     

自体心包瓣膜成型术的临床研究

目的探讨应用自体心包进行心脏二尖瓣、三尖瓣瓣膜成型的技术特点和可行性,评价其术后效果.方法2005-01-2006-06我院采用自体心包成型心脏瓣膜6例,其中男性4例,女性2例.先天性心脏病室间隔缺损合并感染性心内膜炎致三尖瓣关闭不全2例,致二尖瓣关闭不全1例;黏液变性二尖瓣关闭不全3例.4例二尖瓣病变采用了双孔成型技术,同时用自体心包片制作成型环,替代人造瓣环或自体心包片修补后叶.2例三尖瓣病变用自体心包片修补三尖瓣前瓣叶以及隔瓣,瓣环再行De vaga环缩.结果6例患者均顺利出院.随访3个月.术后二尖瓣、三尖瓣返流程度均有明显改善(P<0.05).术后患者心功能均有明显提高(P<0.05).结论自体心包材料能最大限度的发挥瓣膜成型手术的优势,降低并发症,降低手术费用,近期效果良好,长期资料有待进一步的随访.     

三尖瓣关闭不全直视成形术的临床研究

目的 探索理想的三尖瓣成形术方法。方法 自制了三尖瓣成形术的塞规。将40例中、重度继发性三尖瓣关闭不全的患者随机分为两组；术中测量每例患者三尖瓣环的长度；A组行改进的精确量化三尖瓣成形术；B组行精确量化De Vega成形术。观察手术前后血液反流及血流动力学变化。结果 风心病患者三尖瓣前、隔、后瓣环长度之比为：1．27：1：0．9；术后血液反流及血流动力学较术前明显改善，A组较B组改善更好，两组均未发生三尖瓣狭窄。结论 风心病患者三尖瓣环以前、后瓣环扩张为主，隔瓣环基本不扩张。塞规有良好的实用性；精确量化三尖瓣成形术治疗继发性三尖瓣关闭不全，能取得良好的疗效；改进的方法是值得推广的。     

成形软环应用于三尖瓣关闭不全修复的疗效评价

目的:了解国产三尖瓣成形软环对继发于左心系统瓣膜病变造成的三尖瓣关闭不全的治疗效果. 方法:自2002-08至2004-08,我院收治的63例继发性三尖瓣关闭不全病人,在行左心系统瓣膜病变矫治时,应用国产三尖瓣成形软环同期行三尖瓣成形术.49例病人获得随诊,平均随诊时间为17.4±10.3(3～33)个月. 结果:63例病人在术后早期均治愈出院.49例病人随诊时有l例病人死于非三尖瓣成形所致原因;其余48例随诊病人较术前症状均有改善,心功能较术前提高,超声检查示三尖瓣中量反流3例,大量反流1例. 结论:国产三尖瓣成形软环对三尖瓣关闭不全有明显的治疗效果.成形效果优劣的关键在于术中对三尖瓣瓣环的有效处理.三尖瓣瓣环越大,则更应选择相对较小的人工瓣环,成形时不仅要缩小三尖瓣的游离缘瓣环,还要将部分三尖瓣隔瓣瓣环予以缩小和固定.     

自体心包三尖瓣成形与人工瓣环三尖瓣成形的中远期疗效比较

目的 比较自体心包条三尖瓣成形与人工瓣环三尖瓣成形治疗功能性三尖瓣反流的中远期疗效.方法 将2000-2010年间收治的76例功能性三尖瓣反流患者随机分为两组：A组（46例）以人工瓣环行三尖瓣成形,B组（30例）以自体心包条环缩三尖瓣环行三尖瓣成形.分别于术后3年、5年、8年对两组患者右心房内径、右心室内径和三尖瓣反流程度进行对比观察.结果 术后心功能分级较术前提高1～2级,两组患者右心房内径、右心室内径和三尖瓣反流面积比较差异无统计学意义（P＞0.05）.结论 自体心包三尖瓣环成形术是治疗功能性三尖瓣反流的有效方法,其中远期疗效与人工瓣环三尖瓣成形术相似,但治疗费用明显降低.     

“缘对缘”联合人工瓣环修复术治疗二尖瓣关闭不全42例分析

【】 目的 探讨“缘对缘”联合人工瓣环修复二尖瓣成形术治疗二尖瓣关闭不全的手术效果。方法 回顾性分析2004年1月至2008年12月对42例非风湿性二尖瓣关闭不全患者行“缘对缘”联合人工瓣环修复二尖瓣成形术的临床资料,男25例,女17例;年龄12～69岁(36.42±14.28岁),其中先天性二尖瓣病变12例,瓣膜退行性病变20例,缺血性二尖瓣关闭不全7例,感染性心内膜炎3例。术前心脏彩超提示：前叶病变27例,前叶 后叶病变17例;二尖瓣重度反流19例,中度至重度14例,中度反流9例;42例患者均在全身麻醉低温体外循环下应用“缘对缘”联合人工瓣环修复术进行二尖瓣成形术。术中应用250mL注射器向左心室注冰盐水观察评价成形后二尖瓣反流情况,脱离体外循环后经食管超声心动图观察成形结果。分别测量术前及术后二尖瓣反流面积、二尖瓣开口面积、左房内径及左室舒张末期内径,左室射血分数,应用t检验,研究手术前后二尖瓣反流、心脏大小变化、心功能改善情况。检验水准α=0.05。结果 全组无死亡病例,出院时心脏功能(NYHA分级)I级32例,Ⅱ级10例。随访39例,随访时间1-60(24.6±18.2)个月。超声心动图提示：术前二尖瓣反流面积为11.0cm₂±3.8cm₂,术后1年无或微量反流13例,轻度反流17例,轻度至中度反流9例,轻度二尖瓣狭窄1例,反流面积为4.1cm₂±1.4cm₂;术前二尖瓣开口面积4.14 cm₂±1.54cm₂,术后一年为3.58 cm₂±1.10cm₂;术前左心房内径为48.6mm±12.4mm,术后1年为36.5 mm±9.4mm;术前左心室舒张末径为64.3 mm±11.4mm,术后1年为50.6 mm±7.6mm;术前左心室射血分数为54.6%±6.2％,术后1年提高为63.4%±4.0％。结论“缘对缘”联合人工瓣环修复二尖瓣成形术治疗二尖瓣关闭不全手术方法安全、有效,可获得良好的治疗效果。     

Clinical efficacy of two different tricuspid annuloplasty techniques in left cardiac valve surgery

Objective: To investigate the mid-and long-term clinical effects of tricuspid valvuloplasty with the implantation of an artificial plastic ring.Methods: Data of 677 patients who had functional tricuspid regurgitation and left cardiac valve disease and underwent tricuspid valvuloplasty and left cardiac valve surgery were retrospectively.Among these patients, 353 underwent simple suture annuloplasty(group A) while the rest 324 patients underwent artificial plastic ring annuloplasty(group B).The two-year and more-than-two-year clinical and ultrasonocardiograph(UCG) follow-up data of the two groups were obtained and compared.Results: A total of 600 patients(88.6%) completed the long-term follow-up(more than two years).The two-year follow-up showed no significant difference in the incidence of mild tricuspid regurgitation between the two groups(82.2% vs.92.7%, P=0.37).However, there were significantly more cases that developed into moderate to severe tricuspid regurgitation in group A than in group B(17.8% vs.7.3%, P=0.031).The long-term follow-up revealed that the recurrence rate of tricuspid regurgitation in group B was significantly lower than that in group A(11.0% vs.25.0%, P=0.029), and the ratio of cases developing into moderate to severe tricuspid regurgitation in group A was significantly higher than that in group B(28.9% vs.9.9%, P=0.007).The comparison between the two intra-group time segments showed that the development of tricuspid regurgitation in group A was significantly increased(28.9% vs.17.8%, P=0.022), but in group B it was relatively stable(9.9% vs.7.3%, P=0.52).Conclusions: Artificial ring annuloplasty is associated with significantly less tricuspid regurgitation than simple suture annuloplasty.     

Isolated tricuspid valve regurgitation resulting from severe annular dilatation: case report.

A rare case of isolated tricuspid regurgitation (TR) in a 65-year-old man is presented. Echocardiography revealed enlargement of the right atrium, dilatation of the tricuspid valve annulus without thickening or prolapse of the leaflets, and an intact atrial septum. No downward displacement of the tricuspid septal leaflet was observed by echocardiography. Mild mitral regurgitation and severe TR were detected on color flow Doppler studies. Cardiac catheterization indicated elevated right atrial pressure, with a pronounced V-wave. No left-to-right shunt was detected at the right atrium. At surgery, severe annular dilatation of the tricuspid valve (without organically diseased or deformed tricuspid leaflets) was observed, and tricuspid annuloplasty with a prosthetic ring performed. Postoperative echocardiography and right ventriculography showed trivial TR.     

改良三尖瓣成形术对继发性三尖瓣关闭不全的疗效评价

目的:改良Cosgrove-Edwards(CE)三尖瓣成形术对继发性三尖瓣关闭不全(TI)的临床疗效评价.方法:2002-08至2007-12,连续对51例左心系统瓣膜病变,合并中量以上反流的三尖瓣关闭不全患者进行矫治.2004年以前的患者,采用经典的CE三尖瓣成形术(CE组,η=14);2004年后的患者,采用CE改良术(改良CE组,η=37).51例患者根据术中发现,单纯三尖瓣瓣环扩大的为非风湿者(η=37),同时合并风湿性改变的为风湿者(η,=14).术后50例存活患者获得远期随诊,平均术后随诊时间为(47.08±22.08)个月.结果:三尖瓣成形效果的比较①改良CE组与CE组比较,术后三尖瓣瓣环直径[(26.2±1.7)mm vs(27.7±2.0)mm]、三尖瓣成形环的尺寸(28.1±2.1 V8 29.5±1.5)均缩小,术后1周左右残余三尖瓣中量反流的发生率降低(2.7%V8 21.4%),差异有统计学意义(P<0.05).②风湿者与非风湿者三尖瓣成形结果比较:术前既往瓣膜手术史的发生率高(50.0%VS 13.5%),舒张期三尖瓣流速增加[(1.4±0.4)m/s vs(0.9±0.2)m/s],肺动脉收缩压降低[(54.6±22.2)mmHg vs(72.5±22.6)mmHg,1 mmHg=0.133 kPa],三尖瓣瓣环直径[(37.0±6.2)mm vs(48.2±8.3)Inm]缩小,差异均有统计学意义(P<0.05).结论:改良三尖瓣成形术即选择性小号人工瓣环成形方法,对于继发性TI治疗效果良好;同时继发性,TI是一种进行性病变,对其矫治,也应个体化,以期达到最佳的治疗效果.     

Tricuspid valve repair for biopsy-induced regurgitation in a heart transplant recipient

Tricuspid regurgitation (TR) is a frequent complication after heart transplantation. The etiology of TR is multifactorial, but biopsy-induced flail leaflet is one of the most important mechanisms. A 61-year-old woman underwent heart transplant, but experienced several rejection episodes which required multiple surveillance endomyocardial biopsies. At three months after transplant, she required tricuspid valve repair due to symptomatic severe TR. The anterior leaflet was flail, with rupture of primary and secondary chordae. Valve repair was performed with a triple leaflet edge-to-edge technique. The procedure consisted of suture fixation of the prolapsed anterior leaflet joining to the septal and posterior leaflets, and placement of a 30-mm annuloplasty ring. The patient was uneventfully discharged home on day 7 with trivial TR. At a four-years post-transplant evaluation, she was in NYHA functional class I, with preserved ventricular function and trivial TR. She has been followed closely because of post-transplant coronary artery disease.     

预制人工腱索环和二尖瓣成形环置入术治疗二尖瓣脱垂

目的:回顾预制人工腱索环和二尖瓣成形环置入术治疗二尖瓣脱垂,探讨此手术对二尖瓣脱垂的治疗效果。方法:2008年1月至2012年12月间,回顾性分析北京安贞医院收治的15例二尖瓣脱垂患者,其中男性10例,女性5例,年龄(48.5±3.2)岁,SBE后腱索断裂导致关闭不全2例,单纯腱索断裂导致关闭不全8例,腱索延长导致关闭不全5例。术前超声心动图(TEE)显示:根据Carpentier标准,前叶脱垂10例,后叶脱垂3例,前叶合并后叶脱垂2例。所有患者二尖瓣均为重度关闭不全,反流面积(11.0±0.9)cm2,1例合并三尖瓣重度反流。术前射血分数(EF)平均(64.9±1.9)%,左心室舒张末直径(LVDD)平均(54.9±1.4)mm,左心房直径(LA)平均(42.9±1.7)mm。所有患者均经胸正中切口,体外循环下行预制人工腱索环移植,移植腱索数量为(3.6±0.3)根,腱索长度(15.4±1.5)mm,平均体外循环时间(113±11.7)min,平均主动脉阻断时间(86±9.8)min。3例患者置入SJ成形环,12例患者置入爱德华成形环,1例患者同时行三尖瓣成形术。结果:术后无死亡,无恶性心律失常及其他严重并发症。术后复查TEE显示少量反流3例,微量反流8例,未见反流4例。术后EF平均(60.2±2.9)%,未见明显改变。LVDD平均(46.5±1.1)mm,LA平均(32.9±1.2)mm,均较术前明显改善。随访12~57个月,平均(35.7±4.3)个月,少量反流3例,无或微量反流12例。结论:预制人工腱索环和二尖瓣成形环置入术治疗二尖瓣脱垂近中期效果确切,但是远期预后尚需进一步观察。     

Surgical treatment of late tricuspid regurgitation after left cardiac valve replacement

BACKGROUND: The development of late tricuspid regurgitation (TR) following left cardiac valve replacement is an important complication, as it is associated with a severe impairment of exercise capacity and a poor symptomatic outcome. The pathogenesis of this condition remains poorly defined. It is still a challenge in terms of its prevention, treatment and indications for surgical correction. AIMS: To investigate the possible pathogenesis and report the surgical results of the late TR after left cardiac valve replacement. METHODS: There were 56 patients with moderate to severe TR after left cardiac valve replacement, divided into normal prosthesis group (10 patients with normal prosthetic valve function) and dysfunctional prosthesis group (46 patients with prosthetic valve dysfunction). In the normal prosthesis group, 4 patients underwent mitral valve replacement (MVR) and 6 patients underwent combined mitral and aortic valve replacement (DVR). Patients in the dysfunctional prosthesis group included MVR in 36, aortic valve replacement (AVR) in 4 and DVR in 6, with bioprosthetic valve dysfunction occurring in 18, mechanical prosthetic valve obstruction in 22 and periprosthetic valve leakage in 6 patients. At the initial operation, 10 patients underwent DeVega's tricuspid annuloplasty and 46 patients' tricuspid valves were normal. At the second operation, the surgical treatment of TR included tricuspid valve replacement (TVR) in 9 and tricuspid annuloplasty in 47. RESULTS: Two patients died postoperatively giving a 3.6% hospital mortality. The 54 survivors were followed up for 6-132 months (mean of 79.4 months). Heart function improved significantly in 8 with TVR and in 40 with tricuspid annuloplasty. Echocardiography showed moderate TR in 5 and severe TR in 1 patient with tricuspid annuloplasty who need a further surgical treatment. CONCLUSION: Pulmonary hypertension, myocardial dysfunction, and atrial fibrillation might be responsible for the development of late TR after left cardiac valve replacement. Tricuspid annuloplasty, as the surgical method of first choice, resulted in improvement in 87% of patients with late TR after left cardiac valve replacement. TVR can also be safely applied to repair organic disease and the extremely dilated tricuspid valve annulus. If the TR area is more than 25cm(2), the TVR is recommended.     

BalMedic成形软环治疗功能性三尖瓣反流的疗效观察

目的 研究BalMedic成形软环治疗三尖瓣功能性反流的临床效果.方法 同顾性分析18例行左心瓣膜手术同时应用BalMedic成形环行三尖瓣成形术治疗三尖瓣功能性反流患者的临床资料,着重分析手术方法和手术结果,通过胸心脏B超榆查来评估手术前后三尖瓣反流情况.结果 共植入27#成形环13枚(72%,13/18),29#成...