应用Edwards MC3成形环治疗三尖瓣中重度关闭不全临床观察

目的观察Edwards MC3三尖瓣成形环治疗三尖瓣中、重度关闭不全的临床效果。方法51例风湿性心瓣膜病伴中、重度三尖瓣关闭不全患者按手术方式不同分为3组，分别为MC3组21例，Carpentier组12例和De Vega组18例。术后对所有患者均进行随访，分别于术后1周、3个月、6个月、1年、3年行超声心动图检查，观察三尖瓣反流情况，比较3组的手术效果。结果3组均无手术死亡，术后心功能分级均较术前提高1～3级。3组患者术前和术后1周、3个月、6个月、1年、3年三尖瓣反流差别均有统计学意义（均P〈0．05），MC3组三尖瓣反流明显小于其他2组；3组患者1年内反流复发率呈升高趋势，在1年后反流基本趋于稳定，与De Vega和Carpentier组相比，MC3组1年内三尖瓣反流复发率明显降低；随术前三尖瓣中、重度反流病程的延长，术后复发率明显升高。结论应用Edwards MC3三尖瓣成形环治疗三尖瓣中、重度关闭不全的近、中期效果优于De Vega成形术和硬质Carpentier三尖瓣成形环成形术，但其远期效果还有待进一步观察。

Clinical observation of Edwards MC3 ring in tricuspid valve annuloplasty

Objective To observe the clinical effect of Edwards MC3 tricuspid in valve annuloplasty for moderate and severe tricuspid regurgitation(TR). Methods Fifty-one patients with moderate and severe TR were divided into 3 groups. Twenty-one patients were given Edwards MC3 ring tricuspid valve annuloplasty; 12 Carpentier ring tricuspid valve annuloplasty and 18 De Vega tricuspid valve annuloplasty after LCVR were enrolled in this study. The TR grade of these patients were examined by 2D echocardiography preoperatively, 1 week, 3 months, 6 months,1 year and 3 years after surgery. Results There was no morbidity and mortality in three groups. The NYHA clincal function class was improved. The patients of MC3 tricuspid valve annuloplasty showed less residual tricuspid regurgitation than Carpentier ring and De Vega tricuspid valve annuloplasty 3 years after operation. The recurrence rate TR of MC3 ring tricuspid valve annuloplasty was significantly less than the Carpentier ring and De Vega tricuspid valve annuloplasty one year after surgery. Conclusion The early and middle term effect of MC3 ring tricuspid valve annuloplasty is better than that of Carpentier ring and De Vega tricuspid valve annulopla operation duration sty.