应用MC3瓣膜成形环治疗功能性三尖瓣关闭不全效果评价

Evaluation of MC3 valve ring for management of functional tricuspid regurgitation

目的 探讨MC3瓣膜成形环在治疗功能性三尖瓣关闭不全（FTR）中的临床应用效果.方法 回顾性分析郑州大学第一附属医院2012年1月至2014年1月因FTR接受MC3瓣膜成形环三尖瓣成形术的85例患者资料,其中三尖瓣中度反流45例,重度反流40例.通过超声心动图检查,比较术前、术后早期及术后1年三尖瓣反流面积/右心房面积比、右心房横径、三尖瓣环左右径及右心室横径变化情况.结果 术后早期三尖瓣轻度反流81例,中度反流4例.术后1年三尖瓣轻度反流82例,中度反流3例.与术前相比,术后早期及术后1年三尖瓣反流面积/右心房面积比率[（14.9±4.6）％、（13.1±4.3）％比（37.7±8.2）％,均P＜0.05]均显著减少,而右心房横径[（37.2±4.9）、（29.6±5.6）比（42.5±6.1）mm,均P＜0.05]、三尖瓣环左右径[（27.3±1.0）、（27.2±1.0）比（32.2±2.4）mm,均P＜0.05]、右心室横径[（35.5±3.7）、（28.1±4.0）比（36.9±3.4）mm,均P＜0.05]也均显著减小.与术后早期相比,术后1年三尖瓣反流面积/右心房面积比率、右心房横径及右心室横径也均减少,差异均有统计学意义（均P＜0.05）,而三尖瓣环左右径差异无统计学意义（P＞0.05）.随访期间无三尖瓣成形术相关并发症发生.结论 对于功能性三尖瓣关闭不全,应用MC3瓣膜成形环进行三尖瓣成形术具有较好的临床效果.

Objective To evaluate the clinical efficacy of tricuspid valve （TV） annuloplasty with MC3 valve ring for management of functional tricuspid regurgitation（FTR）.Methods A total of 85 patients who accepted TV annuloplasty with MC3 valve ring for management of FTR were retrospectively analyzed,of which included moderate tricuspid regurgitation （TR） （45 cases） and severe TR （40 cases）.The ratio of regurgitant area to RA area,right atrium and ventricular transverse diameter,annulus diameter were measured by echocardiography at three different stages：before,early stage and 1 year after operation.Results At early stage after operation,there were 81 cases of mild TR,4 cases of moderate TR.At 1 year after operation,there were 82 cases of mild TR,3 cases of moderate TR.Compared with the results of pre-operation,the ratio of regurgitant area to RA area,right atrium transverse diameter,annulus diamete and right ventricular transverse diameter at early stage and 1 year after operation were significantly reduced （（14.9±4.6）% and（13.1 ±4.3）% vs（37.7±8.2）%,（37.2±4.9）and（29.6±5.6）vs （42.5 ±6.1）mm,（27.3 ± 1.0）and（27.2 ± 1.0）vs（32.2 ± 2.4） mm,（35.5 ±3.7）and（28.1 ±4.0）vs （36.9 ± 3.4） mm,all P 〈 0.05）.The ratio of regurgitant area to RA area,right atrium and ventricular transverse diameter at early stage after operation were significantly reduced than at 1 year after operation（all P 〈 0.05）,but there was no significant difference in the annulus diameter between early stage and 1 year after operation（P 〉 0.05）.No complications occurred during follow-up.Conclusion TV annuloplasty with MC3 valve ring is effective for the management of FTR.