三尖瓣成形术对心脏瓣膜病的治疗作用

目的总结三尖瓣成形术临床应用的经验,探讨其对心脏瓣膜病的治疗作用。方法回顾分析我院1996-06～2004-1255例三尖瓣病变的外科治疗情况。55例患者中,风湿性心脏病46例,退行性心脏病4例,先天性肺动脉瓣狭窄3例,先天性三尖瓣下移畸形1例,冠心病、二尖瓣关闭不全、三尖瓣关闭不全、左室室壁瘤1例;三尖瓣成形采用改良Kay法32例,DeVega成形术23例。结果全组手术死亡1例,术后0.5年随访出现三尖瓣轻度返流4例,5年发现三尖瓣轻度返流7例,三尖瓣重度返流2例。结论三尖瓣成形术的正确选择有利于预防术后早期出现右心舒张期容量负荷过重、右心衰竭和体循环瘀血。

The significance of tricuspid annuloplasty in the surgical management of cardiac valvular diseases

Objective To summarize the experience of tricuspid annuloplasty in the clinical appliance and explore its implication in the management of cardiac valvular diseases.Method Authors reviewed the surgical treatment of tricuspid insufficiency in 55 cases from Jun,1996. to Dec, 2004, retrospectively. Of the 55 patients, 46 cases were rheumatic heart disease, 4 were degenerative heart disease, 3 were congenital pulmonary artery stenosis,1 was Ebstein's anomaly,one of coronary heart disease,mitral insuffi-ciency,tricuspid insufficiency,left ventricular aneurysm each.32 cases underwent tricuspid annuloplasty with modified Kay method, 23 with DeVega annuloplasty.Results There were one case postoperational death, 4 cases of light tricuspid regurgitation within half-year follow-up, 7 cases of light tricuspid regurgitation within 5-year follow-up and 2 cases of sever tricuspid regurgitation.Conclusion Correct selection of tricuspid annuloplasty can help prevent early postoperational right ventricle diastolic overload, right ventricle failure and congestion of systemic circulation.