肺动脉高压合并三尖瓣中重度反流的外科术式对比

Surgical operation contract of the treatment to medium to severe tricuspid regurgitation

目的探讨三尖瓣Edwards MC3成形环成形术与置换术治疗肺动脉高压合并三尖瓣中重度反流的中远期效果。方法选取患者41例,分为成形环组和置换组,分别行Edwards MC3成形环成形术和St.JudeMedical第3代生物瓣膜置换术,采用彩色多普勒超声随访12～36个月。结果成形环组与置换组相比有较高的三尖瓣反流复发率,置换组有着更为明显的心功能改善。结论对于肺动脉高压合并三尖瓣中重度反流的患者,即便三尖瓣瓣下及瓣叶结构正常也应积极行三尖瓣置换术以提高患者中远期手术效果及生存率。

【Objective】 To evaluate the mid-long-term efficacy of ring annuloplasty and replacement in the treatment of medium to severe functional tricuspid regurgitation with pulmouary hypertension.【Methods】 41 patients were chosen as subjects.The patients were divided into the forming ring group and the replacement group.All the patients were followed up for 12 ～36 months with Color Doppler Ultrasound.【Results】 The forming ring group had a higher recurrence rate of tricuspid regurgitation,the replacement group had a more obvious improvement of heart function.【Conclusion】 For patients with medium to severe tricuspid regurgitation and pulmouary hypertension,even the tricuspid valve leaflets and subvalvular structure are normal,should also receive tricuspid valve replacement surgery,in order to improve the mid-long-term effect of surgery and survival of patients.