三尖瓣环成形治疗功能性三尖瓣反流245例总结

Summary of Tricuspid Annuloplasty in 245 Patients for Treating Functional Tricuspid Regurgitation

目的:对比DeVegar成形术与使用成形环三尖瓣环成形方法在治疗中、重度功能性三尖瓣反流中的有效性。方法:自2003-01至2006-01,对245例中度至重度功能性三尖瓣反流的患者施行了三尖瓣环成形手术。其中,115例施行了DeVegar成形术(DeVegar成形组),130例使用了三尖瓣成形环(成形环组)。成形环组选用的成形环包括:Sovering成形环(n=37)、Carpentier-Edwards Classic成形环(n=41)及Edwards MC3成形环(n=52)。结果:245例患者围手术期共死亡8名,死亡率3.3%。随访期末,DeVegar成形组与成形环组的左心室射血分数、肺动脉收缩压差异均无统计学意义(P>0.05)。DeVegar成形组中度以上三尖瓣反流为21.3%(23/108);成形环组中度以上三尖瓣反流为12.7%(15/118),两组间差异有统计学意义(P<0.01)。结论:在功能性三尖瓣反流治疗中,使用三尖瓣成形环进行三尖瓣成形具有更良好的中期疗效。

Objective ：To compare the efficacy of the DeVegar procedure with ring annuloplasty in the treatment of medium to severe functional tricuspid regurgitation. Methods ： A total of 245 consecutive patients with medium to severe functional tricuspid regurgitation who underwent tricuspid annuloplasty from January 2003 to January 2006 in our hospital were summarized. The patients were divided into two groups, DeVegar procedure group （n = 115 ）, and Ring annuloplasty group （n = 130 ）. Ring annuloplasty group including Sovering ring, 37 patients,Carpentier-Edwards Classic ring,41 patients,and Edwards MC3 ring,52 patients. Results：There were 8 peri-operative deaths （ mortality was 3.3% ）. Follow-up result showed there were no obvious differences between two groups in left ventrieular ejection fraction and pulmonary artery systolic pressure （ P 〉 0. 05 ）. There were 23 （21.3%） patients had greater than medium tricuspid regurgitation in Devegar group, and 15 （ 12. 7% ） in Ring annuloplasy group, the difference was significant （ P 〈 0. 01 ）. Conclusion ： Ring annuloplasty was an effective treatment for functional tricuspid regurgitation with better midterm result.