个体化改良三尖瓣Edwards MC3成形环植入术治疗中重度三尖瓣关闭不全

Evaluation of modified individually Edwards MC3 tricuspid valve annuloplasty for treating the patients with moderate-severe tricuspid regurgitation

目的:对比分析个体化改良Edwards MC3成形环三尖瓣成形术治疗继发中重度三尖瓣关闭不全的临床结果。方法:2005年3月至2007年6月,我们采用Edwards MC3成形环,对72例左心瓣膜手术合并中、重度三尖瓣关闭不全的患者行三尖瓣环成形手术。患者分为两组,经典组采用经典的Edwards MC3三尖瓣成形术,改良组采用个体化非等分法行三尖瓣环成形术,共59例患者获得5年随访。结果:两组患者基本情况、左心手术情况比较差异均无统计学意义(P>0.05);术后随访的改良组三尖瓣瓣环直径[(26.1±1.8)mm vs(27.5±2.2)mm]和三尖瓣中-重度反流的发生率较经典组降低(6.5%vs 28.6%),差异有统计学意义(P<0.05)。结论 :应用个体化改良三尖瓣Edwards MC3成形环植入术,治疗继发性中、重度三尖瓣关闭不全效果良好,但需要更长期的随访观察。

Objective To comparatively analyze the clinical outcome of modified individually Edwards MC3 tricuspid valve annuloplasty for treating the patients with secondary moderate-severe tricuspid regtlrgitation. Methods We performed tricuspid valve annuloplasty with Edwards MC3 ring in 72 patients who suffered from moderate to severe secondary tricuspid valve regurgitation from 2005 to 2007 in our hospital. The patients were divided into two groups. 36 patients received Edwards MC3 tricuspid valve annuloplasty by classical method （classical method group） and 36 patients by modified method （modified method group）. Results Fifty nine patients received the follow-up study at endtime of 5 years. There were no significant differences in two groups of patients about fundamental condition and left-sided valve operation （P 〉 0.05）. The follow-up patients of modified method group had smaller tricuspid valve diameter than the patients of classical method group [ （26.1± 1.8） mm vs （27.5 ±2.2）mm, P 〈 0.05]. And the moderate-severe tricuspid regurgitation in modified method group was less than that in classical method group （6.5% vs 28.6%, P 〈 0.05）. Conclusion The individually modified tricuspid valve annuloplasty with Edwards MC3 annuloplasty ring is effective for treating the secondary moderate- severe tricuspid regurgitation, but need longer-term follow-up study.