三尖瓣成形对于左心瓣膜置换术后远期三尖瓣返流的预防作用

摘要

Objective To discuss the effect of tricuspid valvuloplasty on preventing tricuspid re gurgitation(TR) long after left-sided valve replacement. Methods From January 2001 to June 2006 a to tal of 105 patients complicating slightly TR or not, were undergone left-sided valve replacement. The pa tients were divided into tricuspid-valvuloplasty group (group TA) and un-tricuspid-valvuloplasty group (group NTA) according to whether performed tricuspid valvuloplasty or not. Each patients was per formed echocardiography long term(≥5 years) after surgery, RV, RA, PA, TV AD and the degree of TR were compared bet-ween two groups. Results There were no demographic differences bet-ween two groups previous surgery. Long after surgery, the RV, RA, PAP and TV AD of group TA were im proved; the PAP of group NTA was improved too, but the RV and RA was not improved, and the TVAD was increased; The TVAD of group NTA was greater than group TA, -while the number and the degree of TR in group NTA was obviously serious than in group TA. Conclusion TR may take place in patients complicating slightly TR or not long after left-sided valve replacement. Tricuspid valvuloplasty can effec tively prevent TR long after surgery.%目的 探讨三尖瓣成形(TA)对于左心瓣膜置换术后远期三尖瓣返流(TR)的预防作用.方法 总结2001年1月-2006年6月105例术前无TR或合并轻度TR的左心瓣膜矫治手术病例.根据术中是否行TA术将患者分为成形组(TA组,n=46)和非成形组(NTA组,n＝59).随访≥5年,复查超声心动图并比较右心室前后径(RV)、右心房前后径(RA)、肺动脉压力(PAP)、三尖瓣环直径(TVAD)及TR程度.结果 术前TA组与NTA组各指标无显著差别;远期随访TA组RV、RA、PAP、TVAD均比术前改善(P<0.05);NTA组PAP较术前改善(P <0.05),RV及RA与术前无明显差别,TVAD较术前扩大(P<0.05);NTA组中TVAD明显大于TA组,TR加重例数、程度明显高于TA组.结论 术前无TR或合并轻度TR的左心瓣膜置换术后远期仍可出现TR.TA能够有效预防术后远期TR.