SHORT-TERM EFFECTIVENESS ANALYSIS OF THREE DIFFERENT TRICUSPID VALVE PLASTY FOR FUNCTIONAL TRICUSPID REGURGITATION_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

FANG Zhi , MENG Wei , ZHANG Eryong.

Department of Cardiovascular Surgery, West China Hospital, Sichuan University, Chengdu Sichuan, 610041, P.R.China. Corresponding author: ZHANG Eryong, E-mail: zey16@126.com;

Corresponding author：

Keywords：

Tricuspidregurgitation; Annuloplasty; Kay annuloplasty; DeVaga annuloplasty

DOI：

10.7507/1002-1892.20130269

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Objective To compare and evaluate the short-term outcomes of 3 different tricuspid valve plasty for functional tricuspid regurgitation (TR) in patients with rheumatic heart disease. Methods Between October 2010 and June 2011, 148 patients with rheumatic heart disease undergoing left heart valve replacement and tricuspid valve plasty for functional TR were enrolled in the study. There were 32 males and 116 females with an average age of 47.5 years (range, 15-66 years). The patients were divided into 3 groups depending on tricuspid valve plasty: Cosgrove-Edwards annuloplasty ring group (annuloplasty ring group, 58 cases), Kay annuloplasty group (Kay group, 61 cases), and DeVega annuloplasty group (DeVaga group, 29 cases). There was no significant difference in general data among groups (P gt; 0.05), except more severe TR degree, higher atrial fibrillation, and higher radiofrequency ablation in annuloplasty ring group (P lt; 0.05). Perioperative data were recorded. The heart function was evaluated according to the standard of New York Heart Association (NYHA). Echocardiography (ECG) was used to record the TR class during perioperative period and follow-up. Results After operation, 1 case in Kay group and 1 case in annuloplasty ring group were dead because of low cardiac output syndrome. Pneumonia happened in 2 cases of Kay group and in 1 case of annuloplasty ring group; re-operation was performed in 1 case of annuloplasty ring group because of sternal dehiscence. There was no significant difference in perioperative complication among 3 groups (P=0.840). The TR degree was significantly improved at discharge when compared with preoperative degree in 3 groups (P lt; 0.001). A total of 146 patients were followed up 6-12 months (mean, 7.3 months). The NYHA grade of 3 groups at last follow-up was improved when compared with preoperative grade (P lt; 0.001), but no significant difference among 3 groups (χ2=0.120, P=0.942). The TR degree at last follow-up was all improved in 3 groups when compared with preoperative degree (P lt; 0.001); the improved efficiency showed significant difference among 3 groups (χ2=26.827, P=0.000), it was significantly better in annuloplasty ring group than in the other 2 groups (P lt; 0.001), but no significant difference between DeVega group and Kay group (Z=1.467, P=0.142). Conclusion The early improved efficiency of TR after Cosgrove-Edwards annuloplasty is superior to that of Kay annuloplasty and DeVega annuloplasty.

Citation： FANG Zhi,MENG Wei,ZHANG Eryong.. SHORT-TERM EFFECTIVENESS ANALYSIS OF THREE DIFFERENT TRICUSPID VALVE PLASTY FOR FUNCTIONAL TRICUSPID REGURGITATION. Chinese Journal of Reparative and Reconstructive Surgery, 2013, 27(10): 1230-1233. doi: 10.7507/1002-1892.20130269 Copy

1.	Perier P, Jeserich M, Vieth M, et al. Mitral valve reconstruction in a patient with Libman-Sacks endocarditis: a case report. J Heart Valve Dis, 2011, 20(1): 103-106.
2.	Kim JB, Yoo DG, Kim GS, et al. Mild-to-moderate functional tricuspid regurgitation in patients undergoing valve replacement for rheumatic mitral disease: the influence of tricuspid valve repair on clinical and echocardiographic outcomes. Heart, 2012, 98(1): 24-30.
3.	Garatti A, Canziani A, Mossuto E, et al. Tricuspid valve replacement with mechanical prostheses: long-term results. J Heart Valve Dis, 2010, 19(2): 194-200.
4.	Shah PM, Raney AA. Tricuspid valve disease. Curr Probl Cardiol, 2008, 33(2): 47-84.
5.	Colombo T, Russo C, Ciliberto GR, et al. Tricuspid regurgitation secondary to mitral valve disease: tricuspid annulus function as guide to tricuspid valve repair. Cardiovasc Surg, 2001, 9(4): 369-377.
6.	Singh SK, Tang GH, Maganti MD, et al. Midterm outcomes of tricuspid valve repair versus replacement for organic tricuspid disease. Ann Thorac Surg, 2006, 82(5): 1735-1741.
7.	许建屏, 潘世伟, 葛翼鹏. 三尖瓣改良DeVega环缩术与人工软环成形术效果比较. 中华胸心血管外科杂志, 2006, 22(2): 134-135.
8.	Carrier M, Pellerin M, Guertin MC, et al. Twenty-five years’ clinical experience with repair of tricuspid insufficiency. J Heart Valve Dis, 2004, 13(6): 952-956.
9.	Kim HK, Lee SP, Kim YJ, et al. Tricuspid regurgitation: clinical importance and its optimal surgical timing. J Cardiovasc Ultrasound, 2013, 21(1): 1-9.
10.	Benedetto U, Melina G, Angeloni E, et al. Prophylactic tricuspid annuloplasty in patients with dilated tricuspid annulus undergoing mitral valve surgery. J Thorac Cardiovasc Surg, 2012, 143(3): 632-638.
11.	Rogers JH, Bolling SF. The tricuspid valve: current perspective and evolving management of tricuspid regurgitation. Circulation, 2009, 119(20): 2718-2725.
12.	胡佳, 康宁, 万松. 外科修复功能性三尖瓣反流: 旧课题的新认识. 中国胸心血管外科临床杂志, 2010, 17(6): 494-498.
13.	Navia JL, Nowicki ER, Blackstone EH, et al. Surgical management of secondary tricuspid valve regurgitation: Annulus, commissure, or leaflet procedure? J Thorae Cardiovasc Surg, 2010, 139(6): 1473-1482．.
14.	Khorsandi M, Banerjee A, Singh H, et al. Is a tricuspid annuloplastyring significantly better than a De Vega’s annuloplasty stitch when repairingsevere tricuspid regurgitation? Interact Cardiovasc Thorac Surg, 2012, 15(1): 129-135.
15.	Bonow RO, Carabello BA, Chatterjee K, et al. 2008 Focused update incorporated into the ACC/AHA 2006 guidelines for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 1998 Guidelines for the Management of Patients With Valvular Heart Disease): endorsed by the Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. Circulation, 2008, 118(15): e523-661.
16.	Vahanian A, Alfieri O, Andreotti F, et al. Guidelines on the management of valvular heart disease (version 2012). Eur Heart J, 2012, 33(19): 2451-2496.
17.	庞中一, 陆龙. 功能性三尖瓣反流的改良DeVega成形环缩术与经典DeVega环缩术疗效分析. 医学研究杂志, 2009, 38(4): 98-100.
18.	张嵬. 三尖瓣瓣环成形术临床研究现状. 河北北方学院学报: 医学版, 2008, 25(2): 77-80.

1. Perier P, Jeserich M, Vieth M, et al. Mitral valve reconstruction in a patient with Libman-Sacks endocarditis: a case report. J Heart Valve Dis, 2011, 20(1): 103-106.
2. Kim JB, Yoo DG, Kim GS, et al. Mild-to-moderate functional tricuspid regurgitation in patients undergoing valve replacement for rheumatic mitral disease: the influence of tricuspid valve repair on clinical and echocardiographic outcomes. Heart, 2012, 98(1): 24-30.
3. Garatti A, Canziani A, Mossuto E, et al. Tricuspid valve replacement with mechanical prostheses: long-term results. J Heart Valve Dis, 2010, 19(2): 194-200.
4. Shah PM, Raney AA. Tricuspid valve disease. Curr Probl Cardiol, 2008, 33(2): 47-84.
5. Colombo T, Russo C, Ciliberto GR, et al. Tricuspid regurgitation secondary to mitral valve disease: tricuspid annulus function as guide to tricuspid valve repair. Cardiovasc Surg, 2001, 9(4): 369-377.
6. Singh SK, Tang GH, Maganti MD, et al. Midterm outcomes of tricuspid valve repair versus replacement for organic tricuspid disease. Ann Thorac Surg, 2006, 82(5): 1735-1741.
7. 许建屏, 潘世伟, 葛翼鹏. 三尖瓣改良DeVega环缩术与人工软环成形术效果比较. 中华胸心血管外科杂志, 2006, 22(2): 134-135.
8. Carrier M, Pellerin M, Guertin MC, et al. Twenty-five years’ clinical experience with repair of tricuspid insufficiency. J Heart Valve Dis, 2004, 13(6): 952-956.
9. Kim HK, Lee SP, Kim YJ, et al. Tricuspid regurgitation: clinical importance and its optimal surgical timing. J Cardiovasc Ultrasound, 2013, 21(1): 1-9.
10. Benedetto U, Melina G, Angeloni E, et al. Prophylactic tricuspid annuloplasty in patients with dilated tricuspid annulus undergoing mitral valve surgery. J Thorac Cardiovasc Surg, 2012, 143(3): 632-638.
11. Rogers JH, Bolling SF. The tricuspid valve: current perspective and evolving management of tricuspid regurgitation. Circulation, 2009, 119(20): 2718-2725.
12. 胡佳, 康宁, 万松. 外科修复功能性三尖瓣反流: 旧课题的新认识. 中国胸心血管外科临床杂志, 2010, 17(6): 494-498.
13. Navia JL, Nowicki ER, Blackstone EH, et al. Surgical management of secondary tricuspid valve regurgitation: Annulus, commissure, or leaflet procedure? J Thorae Cardiovasc Surg, 2010, 139(6): 1473-1482．.
14. Khorsandi M, Banerjee A, Singh H, et al. Is a tricuspid annuloplastyring significantly better than a De Vega’s annuloplasty stitch when repairingsevere tricuspid regurgitation? Interact Cardiovasc Thorac Surg, 2012, 15(1): 129-135.
15. Bonow RO, Carabello BA, Chatterjee K, et al. 2008 Focused update incorporated into the ACC/AHA 2006 guidelines for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 1998 Guidelines for the Management of Patients With Valvular Heart Disease): endorsed by the Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. Circulation, 2008, 118(15): e523-661.
16. Vahanian A, Alfieri O, Andreotti F, et al. Guidelines on the management of valvular heart disease (version 2012). Eur Heart J, 2012, 33(19): 2451-2496.
17. 庞中一, 陆龙. 功能性三尖瓣反流的改良DeVega成形环缩术与经典DeVega环缩术疗效分析. 医学研究杂志, 2009, 38(4): 98-100.
18. 张嵬. 三尖瓣瓣环成形术临床研究现状. 河北北方学院学报: 医学版, 2008, 25(2): 77-80.

Chinese Journal of Reparative and Reconstructive Surgery

SHORT-TERM EFFECTIVENESS ANALYSIS OF THREE DIFFERENT TRICUSPID VALVE PLASTY FOR FUNCTIONAL TRICUSPID REGURGITATION

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