west china medical publishers
Keyword
  • Title
  • Author
  • Keyword
  • Abstract
Advance search
Advance search

Search

find Keyword "三尖瓣关闭不全" 27 results
  • Clinical Application of Annuloplasty Ring in Tricuspid Valvuloplasty for the Treatment of Tricuspid Regurgitation

    Objective To observe early and intermediate-term clinical outcomes of tricuspid valvuloplasty withannuloplasty ring for the treatment of secondary tricuspid regurgitation (TR) of patients with rheumatic heart disease. MethodsFrom December 2009 to September 2011, 41 patients with rheumatic heart disease underwent left-side heart valve replacementand concomitant tricuspid valvuloplasty with annuloplasty ring in Sichuan Jianyang People’s Hospital. There were 12 males and 29 females with their mean age of 49 (21-67) years. Preoperatively, there were 38 patients with atrial fibrillation, 13 patients with left atrial thrombus; 2 patients with trivial TR, 5 patients with mild TR, 11 patients with moderate TR, and 23 patients with severe TR. Twenty-eight patients received mitral valve replacement and 13 patients received mitral and aortic valve replacement. All the patients were followed up every 3 months at the outpatient department, and received color Doppler echocardiography examination to observe TR degree at the 6th postoperative month. Results Postoperative heart function improved by 2-3 class in all the patients. There were 39 patients with New York Heart Association (NYHA) classⅠorⅡ postoperatively, and postoperative heart function was significantly better than preoperative heart function(P<0.05). All the patients were followed up for 6-27 months, and there was no death during follow-up. Color Doppler echocardiography at the 6th postoperative month showed that TR degrees were significantly decreased than preoperative TR degrees. There were 39 patients with trivial or mild TR during follow-up, which was significantly different with preoperativeTR degree (P<0.05). Right ventricle dimension decreased from preoperative 20 mm to 17 mm during follow-up, which were statistically different (P<0.05). Conclusion Early and intermediate-term clinical outcomes of tricuspid valvuloplasty with annuloplasty ring for the treatment of TR are satisfactory, while further evaluation for its long-term outcome is needed.

    Release date:2016-08-30 05:45 Export PDF Favorites Scan
  • 二尖瓣病变合并肺动脉高压致三尖瓣关闭不全的外科处理及中期随访

    目的 探讨二尖瓣病变合并肺动脉高压致三尖瓣关闭不全外科治疗的方法,总结相关治疗经验。 方法 回顾性分析2005年6月至2011年6月我院行外科手术治疗二尖瓣病变合并肺动脉高压致三尖瓣关闭不全118例患者的临床资料,男52例、女66例,年龄31~68 (48.25±9.83) 岁。三尖瓣轻度反流28例,中度反流59例,重度反流31例。所有患者术前均有不同程度的肺动脉高压(38~82 mm Hg)。术中行二尖瓣手术时同期行三尖瓣手术。体外循环停机后,术中采用经食管超声心动图(TEE)评价术后即刻治疗效果,出院前再次复查经胸超声心动图评价手术治疗效果。 结果 术中TEE结果提示,三尖瓣无反流50例,轻度反流67例,1例患者三尖瓣成形术后仍存在重度反流,遂再次在体外循环下行三尖瓣置换术。术后早期死亡4例(3.39%),其余患者均痊愈出院。随访12~84(41.72±22.90) 个月,完整随访105例,远期死亡3例,其余患者三尖瓣无反流30例,轻度反流66例,中度反流4例,重度反流2例。全组患者术后5年生存率为93.6%±2.4%;术后5年三尖瓣免除再手术率为94.9%±3.6%。 结论 对二尖瓣病变合并肺动脉高压所致的功能性三尖瓣关闭不全患者,在解决二尖瓣病变时同期纠治存在的三尖瓣病变,可降低术后三尖瓣的再手术率,早、中期疗效满意。术中根据三尖瓣瓣环的扩张程度选择适当的手术方式是提高手术治疗效果的关键。

    Release date:2016-08-30 05:47 Export PDF Favorites Scan
  • Ring Annuloplasty Using Prosthetic Vascular Graft for the Treatment of Tricuspid Regurgitation:Experience in 56 Patients.

    Abstract: Objective To evaluate the surgical effect of ring annuloplasty using prosthetic vascular graft for the treatment of tricuspid regurgitation. Methods From July 2000 to July 2010, ring annuloplasty using prosthetic vascular graft was performed to a total of 56 patients with tricuspid regurgitation in Changhai Hospital of Second Military Medical University. There were 24 male patients and 32 female patients. Their mean age was(45.7±21.8)years (ranging from 14 to 73 years). All the patients were diagnosed as moderate to severe tricuspid regurgitation by color Doppler echocardiography examination, including 47 patients with rheumatic heart valve diseases, and 9 patients with congenital heart disease (Ebstein’s anomaly). All the 56 patients underwent ring annuloplasty using prosthetic vascular graft instead of Carpentier annuloplasty ring for the treatment of tricuspid regurgitation. Results There was no in-hospital death. Postoperatively, one patient had acute respiratory failure, one patient had acute kidney failure, and one patient had re-exploration for bleeding. All patients had none or mild tricuspid regurgitation by echocardiography examination one month after surgery. Forty eight patients were followed up from 1.0 to 9.5 years with a median follow-up time of 3.8 years. During follow-up, there was no late death, but one patient had brain embolism as an anticoagulation complication. Sixteen patients were in New York Heart Association (NYHA) functional classⅠ, 26 patients in NYHA classⅡ, and 6 patients in NYHA class Ⅲ. Thirty six patients had no tricuspid regurgitation, 10 patients had mild tricuspid regurgitation, and 2 patients had moderate tricuspid regurgitation by echocardiography examination during follow-up. Conclusion The early and mid-term follow-up results of ring annuloplasty using prosthetic vascular graft instead of Carpentier annuloplasty ring for the treatment of tricuspid regurgitation are satisfactory. It is a good choice for the surgical treatment of tricuspid regurgitation.

    Release date:2016-08-30 05:49 Export PDF Favorites Scan
  • Progress in Surgical Treatment of Secondary Tricuspid Insufficiency

    Abstract: Tricuspid insufficiency founded in the setting of left-sided heart disease is usually secondary tricuspid insufficiency caused by tricuspid valve annular dilation. Some patients had rheumatic tricuspid valve diseases. Tricuspid valve repair rather than valve replacement is recommend for functional tricuspid regurgitation. Linear annuloplasty and ring annuloplasty are two main tricuspid valve repair methods. However, the indications for treatment of secondary tricuspid regurgitation remain controversial. The optimal surgical repair technique to eliminate secondary tricuspid regurgitation remains challenging. In this article, we review the assessment of tricuspid valve lesions, criteria for correction, and surgical management of secondary tricuspid insufficiency.methods. However, the indications for treatment of secondary tricus

    Release date:2016-08-30 05:49 Export PDF Favorites Scan
  • 三尖瓣关闭不全外科治疗282例

    目的 探讨三尖瓣关闭不全(TI)外科治疗时机、手术方式与疗效的关系。 方法 回顾性分析中山大学附属第一医院2003年1月至2010年10月手术治疗的282例TI患者的临床资料,其中男115例,女167例;年龄(42.00±15.90) 岁。按手术方式分为三尖瓣置换术(TVR)34例,三尖瓣成形术(TVP)248例(包括改良De Vega成形术、Kay’s成形术、瓣裂修补术、人工瓣环成形术),评价患者疗效。 结果 术后早期死亡13例,死于低心排血量综合征7例,室性心律失常3例,感染性休克2例,心脏破裂1例。早期死亡率为4.61% (13/282)。手术时间(167.47±37.34) min,体外循环时间(109.67±27.98) min,主动脉阻断时间(66.20±18.42) min,住院时间(16.46±5.29) d。术后1年随访249例,三尖瓣反流改善总有效率为90.76% (226/249)),其中改良De Vega成形术有效率为91.41% (117/128),Kay’s成形术为80.49% (33/41),瓣裂修补术为92.31% (24/26),人工瓣环成形术为96.00% (24/25),TVP为96.55%(28/29)。术后肺动脉压较术前明显降低(P<0.01),右心室内径缩小。 结论 对中-重度TI或瓣环明显扩大者,应积极手术干预;Kay’s成形术后三尖瓣反流复发率较高,人工瓣环成形术效果良好;对于瓣膜发育不良或毁损者应首选TVR。

    Release date:2016-08-30 05:50 Export PDF Favorites Scan
  • 风湿性心瓣膜病三尖瓣关闭不全的外科治疗

    目的 总结风湿性心瓣膜病三尖瓣关闭不全( TI)手术治疗的临床经验,以提高对该类患者的治疗效果。 方法 1999年1月至2009年1月安徽医科大学第一附属医院对167例风湿性心瓣膜病累及三尖瓣患者行手术治疗,其中男76例,女91例;年龄16.0~75.0岁(40.7±10.4岁);病程2.0~35.0年(13.2±3.8年)。112例轻度至中度三尖瓣反流采用改良或节段性De Vega成形术,40例中度或中度至重度三尖瓣反流采用Kay或改良Kay成形术;12例因瓣环扩张明显、反流量大,行人工瓣环成形术,三尖瓣置换术3例。术后观察三尖瓣反流情况,随访超声心动图结果。 结果 术后早期死亡6例,其中死于心搏骤停1例,肾功能衰竭2例,脑血管意外1例,心室破裂1例,纵隔感染致败血症1例。1例术中因低心排血量使用主动脉内球囊反搏(IABP)治疗,治愈出院。随访159例,随访时间3~123个月,失访2例。随访期间心功能分级(NYHA)Ⅰ级115例,Ⅱ级32例,Ⅲ级12例。三尖瓣轻度反流15例,中度反流5例,重度反流2例。随访期间三尖瓣隔瓣与前瓣瓣环间直径(2.1±0.3 cm vs. 3.5±0.4 cm, P=0.000)、三尖瓣瞬时反流量(1.8±0.6 ml vs. 7.8±3.5 ml, P=0.001)和右心房容积(54.2±18.4 ml vs. 67.8±22.5 ml, P=0.012)较术前明显减少或缩小; 射血分数(56.1%±7.2% vs. 54.3%±6.5%,P=0.313)较术前有所提高。 结论 心脏瓣膜病中TI需引起重视,应选择适宜的方法积极治疗。

    Release date:2016-08-30 05:56 Export PDF Favorites Scan
  • 分段改良De Vega三尖瓣成形术治疗功能性三尖瓣关闭不全

    目的 评价分段改良De Vega三尖瓣成形术治疗功能性三尖瓣关闭不全(FTR)的临床疗效,总结治疗经验。 方法 选择2006年10月至2007年12月在我院手术治疗的风湿性二尖瓣病变合并FTR患者共58例,根据三尖瓣成形手术方式的不同分为两组,改良组:26例,男8例,女18例;年龄49.6±11.8岁;接受分段改良De Vega三尖瓣成形术。传统组:32例,男6例,女26例;年龄47.9±12.8岁;接受传统改良De Vega三尖瓣成形术。于围手术期用超声心动图测量两组患者三尖瓣瞬时反流量、三尖瓣瓣环周径,并随访术后三尖瓣反流情况。 结果 两组术后三尖瓣瞬时反流量均较术前减少(Plt;0.05),组间比较差异无统计学意义(F=1.969,Pgt;0.05);三尖瓣瓣环周径均较术前明显缩小(Plt;0.01),组间比较差异无统计学意义(F=2.336,Pgt;0.05);两组均无因三尖瓣反流再次手术者。随访6~12个月时,两组患者三尖瓣反流情况较出院前明显改善,组间比较差异无统计学意义(Pgt;0.05)。 结论 分段改良De Vega三尖瓣成形术,能较为有效地纠正FTR,并可取得满意的近期疗效。

    Release date:2016-08-30 06:02 Export PDF Favorites Scan
  • Edwards MC3成形环行三尖瓣成形术治疗中至重度三尖瓣反流

    目的 探讨Edwards MC3成形环在三尖瓣中、重度关闭不全患者中行三尖瓣成形术的近、中期效果,总结临床经验。 方法 2004年6月至2007年12月我科收治心脏病(包括风湿性心瓣膜病、房间隔缺损、Ebstein畸形)伴中、重度三尖瓣关闭不全患者55例,其中男28例,女27例;年龄28~78岁,平均年龄50.50岁;三尖瓣中度反流22例,重度反流33例。根据手术方式不同将55例患者分为3组:De Vega成形组(De Vega组):18例,行De Vega成形术;硬质Carpentier成形环成形组(Carpentier组):12例,用硬质Carpentier成形环行三尖瓣成形术;Edwards MC3成形环成形组(MC3组):25例,用Edwards MC3成形环行三尖瓣成形术。术后比较3组的手术疗效,对所有患者均进行随访,在不同的时间采用彩色超声心动图观察术后三尖瓣的反流情况。 结果 术后3组患者均无手术死亡;随访55例,随访时间0.5~4.0年。术后心功能分级均较术前改善2~3级;术后3个月、1年和3年超声心动图检查提示:MC3组三尖瓣反流明显少于其他两组(Plt;0.05);与De Vega组和Carpentier组比较,MC3组患者三尖瓣反流的复发率明显降低(Plt;0.05)。 结论 应用Edwards MC3成形环行三尖瓣成形术, 其近、中期效果优于De Vega成形术和硬质Carpentier三尖瓣成形术,但其远期效果还有待进一步随访观察。

    Release date:2016-08-30 06:02 Export PDF Favorites Scan
  • 双孔三尖瓣成形术治疗外伤性三尖瓣关闭不全

    目的 报告用双孔三尖瓣成形技术治疗外伤性三尖瓣关闭不全的临床结果 ,并分析总结该方法的临床经验。 方法  2 0 0 0年 1月~ 2 0 0 3年 9月对 5例外伤性三尖瓣关闭不全患者采用双孔三尖瓣成形技术治疗 ,其中前乳头肌撕脱 2例 ,前叶腱索断裂 3例。 结果 无手术死亡 ,无术后并发症及再次手术 ;出院前超声心动图检查显示三尖瓣血流正常 2例 ,微量反流 3例 ;门诊随访 8~ 36个月 ,三尖瓣血流正常 1例 ,少量反流 4例。 结论 双孔三尖瓣成形技术治疗外伤性三尖瓣关闭不全 ,其方法简单有效。病例选择合适 ,能获得满意的治疗效果。

    Release date:2016-08-30 06:24 Export PDF Favorites Scan
  • 三尖瓣硬质人工瓣环成形术的中期效果评价

    目的评价硬质三尖瓣成形环对三尖瓣成形的中期效果。方法对风湿性心瓣膜病伴中、重度三尖瓣关闭不全患者应用硬质Carpentier三尖瓣成形环行三尖瓣成形术15例(人工瓣环成形组),术前三尖瓣每搏反流量31.9±7.6ml;并与同期16例行Kay及DeVega三尖瓣成形术患者(对照组)进行比较,对照组术前三尖瓣每搏反流量25.3±6.9ml。术后对所有患者均进行随访,用彩色超声心动图观察术后三尖瓣反流情况。结果两组均无手术死亡,术后心功能分级均较术前提高1~2级。出院前和术后6个月,两组患者三尖瓣反流量差别无统计学意义,术后随访1、2、3年,人工瓣环成形组三尖瓣反流量小于对照组(Plt;0.05,0.05,0.01)。结论应用硬质三尖瓣成形环对三尖瓣进行成形,其中期效果明显优于Kay和DeVega成形术。

    Release date:2016-08-30 06:25 Export PDF Favorites Scan
3 pages Previous 1 2 3 Next

Format

Content