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find Keyword "三尖瓣成形" 32 results
  • The Efficacy of Modified De Vega Technique Compares with the Traditional De Vega Technique for the Correction of Severe Tricuspid Regurgitation

    摘要:目的:探讨改良De Vega环缩术与经典De Vega环缩术相比对于治疗重度三尖瓣返流是否具有更好的成形效果。方法: 2007年12月至2009年3月对29例重度三尖瓣返流的患者行De Vega环缩术。其中16例行改良De Vega环缩术,13例行经典De Vega环缩术,随访比较两组患者三尖瓣返流程度,右心室舒张期末内径,EF值及心功能分级。以秩和检验分析研究两组患者三尖瓣返流程度和心功能分级的差异,以t检验研究两组患者右心室舒张末期内径及EF值变化。结果:术前两组患者一般指标无显著差异。两组患者随访时间无显著差异。随访经典De Vega组重度返流1例,中度返流5例,轻度返流5例,微量及无返流2例;改良De Vega组无中、重度返流,轻度返流8例,微量及无返流8例。经分析显示两组患者三尖瓣返流程度结果差异有统计学意义(Plt;0.05)。经典De Vega组心功能分级I级5例,II级7例,III级1例;改良De Vega组I级7例,II级8例,III级1例,两组患者心功能差异无统计学意义(Pgt;0.05)。两组患者右室舒张期末内径及EF值组内比较随访与术前差异均有统计学意义(Plt;0.05),随访时组间比较差异有统计学意义(Plt;0.05), 改良De Vega环缩术随访时右室舒张期末内径缩小更显著,射血分数改善更明显。结论:改良De Vega环缩术治疗重度三尖瓣返流效果优于经典De Vega环缩术。Abstract: Objective: To compare the efficacy of one kind of modified De Vega technique and traditional De Vega technique for the correction of severe tricuspid regurgitation. Methods: From December 2007 to March 2009, 29 patients were treated with tricuspid valve annuloplasty. These were 16 patients in modified De Vega annuloplasty group and the others (13 patients) in traditional De Vega annuloplasty group. The grade of tricuspid regurgitation、New York Heart Association (NYHA) functional class、ejection fraction (EF) and the right ventricular enddiastolic dimension of two groups were followed and reviewed. Results: There was no statistically difference between two groups about preoperative characteristics and followup time. There was 1 patient with severe TR, 5 patients with moderate TR, 5 patients with mild TR and 2 patients without TR in traditional De Vega annuloplasty group after the operations. In modified De Vega annuloplasty group, no patient was observed with severe or moderate TR, 8 patients with mild TR, and 8 patients without TR. At interval time, there was significant difference in the grade of tricuspid regurgitation between two groups (Plt;0. 05). Both tricuspid valve plasty techniques could reduce the right ventricular enddiastolic dimension and improve ejection fraction significantly (Plt; 0. 05), and there was significant difference in the right ventricular enddiastolic dimension and ejection fraction at interval time between two groups (Plt;0.05). Conclusions: The outcome of modified tricuspid De Vega technique is superior to that of traditional De Vega technique in correcting severe tricuspid regurgitation.

    Release date:2016-08-26 03:57 Export PDF Favorites Scan
  • 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
  • 改良三尖瓣成形术的效果评价

    目的 比较一种改良三尖瓣成形术与Kay 成形术的成形效果,总结治疗经验。 方法 回顾性分析江苏省人民医院2006 年1 月至2008 年1 月60 例功能性三尖瓣反流患者的临床资料。按手术方式不同将60 例患者分为两组:改良三尖瓣成形术组(改良组),30 例,其中男14 例,女16 例;年龄(42.80±5.70)岁;Kay 成形术组,30 例,其中男15 例,女15 例;年龄(45.30±8.30)岁。术前两组患者的年龄、性别、心功能分级(NYHA)和三尖瓣反流分级差异均无统计学意义(P > 0.05)。比较两组患者术前、术后住院及术后随访期间的右心房横径、右心室舒张期末内径和三尖瓣反流面积。 结果 两组患者手术时间、体外循环时间、住重症监护室时间、呼吸机辅助时间、住院时间差异均无统计学意义。术后全部患者痊愈出院。改良组随访时间为(19.62±8.65)个月,远期1 例死于肺部感染;随访三尖瓣无反流13 例,Ⅰ级反流14 例,Ⅱ级反流2 例,Ⅲ级反流1 例,无Ⅳ级反流。Kay 成形术组随访时间为(18.96±9.23)个月,远期死亡2 例,分别死于顽固性右心衰竭和脑出血;随访无三尖瓣反流9 例,Ⅰ级反流12 例,Ⅱ级反流5 例,Ⅲ级反流2 例,Ⅳ级反流2 例。术后早期改良组和Kay 成形术组右心房横径[(4.51±0.85)cm vs. (5.69±1.21) cm]、右心室舒张期末内径[(2.85±0.45) cm vs.( 3.47±0.83) cm] 和三尖瓣反流面积[(4.17±2.54) cm2 vs.( 25.12±2.39 cm2)] 较术前均明显下降(P < 0.05);术后随访改良组和Kay成形术组右心房横径[(3.95±0.66) cm vs.( 4.52±0.38) cm,P=0.705] 差异无统计学意义,右心室舒张期末内径[(2.59±0.63)cm vs.( 2.98±0.47) cm, P=0.002] 和三尖瓣反流面积[(8.76±3.45) cm2 vs.( 12.16±5.28) cm2, P=0.004] 改良组优于Kay 成形术组。 结论 改良三尖瓣成形术的远期成形效果优于Kay 成形术。

    Release date:2016-08-30 05:48 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
  • 51例Ebstein畸形的外科治疗

    目的 总结Ebstein 畸形的外科治疗经验。 方法 回顾性分析2002年1月至2011年8月河南省胸科医院51例Ebstein畸形患者经外科手术治疗的临床资料,其中男22例,女29例;平均年龄15.8 (0.8~48.0)岁;平均体重35.3 (7.0~68.0) kg。Carpentier分型A型12例、B型34例、C型5例。超声心动图(UCG)提示:三尖瓣轻度反流7例,中度反流8例,重度反流36例。手术中应用褥式缝合上提隔瓣和后瓣,平行折叠房化右心室加三尖瓣环缩术21例,Carpentier法8例,二瓣化法11例,纵向折叠房化心室加三尖瓣成形术4例,三尖瓣机械瓣置换术3例,生物瓣置换术2例;另有2例因右心室发育不良仅做双向格林手术。17例患者于三尖瓣成形术后加做双向格林手术。 结果 围术期死亡2例,均死于低心排血量。术后随访49例,平均随访时间32 (2~102)个月。随访期间心功能分级(NYHA)Ⅰ级30例、Ⅱ级19例;三尖瓣中度反流8例,轻度反流6例,无反流35例。3例三尖瓣机械瓣置换术患者的机械瓣、2例生物瓣置换术的生物瓣功能均正常。患者恢复正常的生活或工作,无需再次手术患者。 结论 对Ebstein 畸形要根据不同的病情采取相应的手术治疗方法,可以获得良好的手术效果。

    Release date:2016-08-30 05:51 Export PDF Favorites Scan
  • Clinical Outcomes of Tricuspid Annuloplasty Using a C-type Ring Made of Autologous Pericardium

    Abstract: Objective To evaluate clinical outcomes of tricuspid annuloplasty using a C-type ring made of autologous pericardium for the treatment of functional tricuspid regurgitation (TR). Methods Eleven patients underwent tricuspid annuloplasty in Guizhou Provincial People’s Hospital between March 2009 and January 2011, including 5 male patients and 6 female patients with their age of 32-57 (43.80±12.20) years. There were 3 patients with mild TR, 7 patients with moderate TR, and 1 patient with severe TR. Concomitant procedures included mitral valve replacement and/or aortic valve replacement and/or left atrial thrombectomy. The C-type ring was created using a strip of pericardium after 0.8% glutaraldehyde fixation for 15 minutes. Interrupted horizontal mattress suture was used to secure the C-type ring to the tricuspid annulus. Hear function and echocardiography were examined during follow-up. Results There was no in-hospital death, and the hospital stay was 15-28 (21.10±3.80) days. All the patients were followed up for 8-28 (18.50±7.00)months. There was no death or reoperation because of TR or tricuspid stenosis during follow-up. Ten patients had TR during follow-up, including 9 patients with mild TR and 1 patient with mild to moderate TR, but there was no patient with severe TR. The degree of TR during follow-up was significantly reduced than preoperative degree (Z =-2.81,P<0.05). Preoperative and postoperative right ventricular dimension (19.95±5.11 mm vs. 21.57±12.81 mm,P=0.705) and right atrial dimension(37.55±6.79 mm vs. 35.55±5.22 mm,P=0.317)were not statistically different. Conclusion Tricuspid annuloplasty using a C-type ring made of autologous pericardium has satisfactory clinical outcomes for patients with functional TR.

    Release date:2016-08-30 05:51 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
  • Mild Functional Tricuspid Regurgitation Approach to Mitral Valve Repair

    Abstract: Objective To explore whether clinically mild functional tricuspid regurgitation should be addressed at the time of mitral valve repair (MVP) for moderate or severe mitral regurgitation due to myxomatous degeneration. Methods We retrospectively analyzed the outcomes of 135 patients with moderate or severemitral regurgitation due to myxomatous degeneration with mild functional tricuspid regurgitation. All patients were treated between January 1993 and March 2008 in the Department of Cardiothoracic Surgery of Changhai Hospital, the Second Military Medical University. We divided the patients into a MVP group (n=76) and a MVP+tricuspid valvuloplasty (TVP) group(n=59) according to whether they underwent combined TVP, and observed the perioperative mortality rate, degree of tricuspid regurgitation, and compared survival rate, and freedom from longterm moderate or severe tricuspid regurgitation after operation. Cox regression was used to analyzethe risk factors for longterm moderate or severe tricuspid regurgitation after operations. Results (1) There were no deaths during the perioperative period, and postoperative transthoracic echocardiography of all patients indicated that tricuspid regurgitation was mild or less. (2) Survival rate at 5 years, 10 years after operations in MVP group was 98.4%, 95.0%, respectively, and survival rate at 5 years, 10 years after operations in MVP+TVP group was 100.0%, 93.7%, respectively, and there was no significant difference in the survival rate after operations between the two groups(P=0.311), butthere was a significant difference in the freedom from longterm moderate or severe tricuspid regurgitation after operations between the two groups (P=0.040). Multivariate Cox regression showed that preoperative pulmonary artery pressure gt;30 mm Hg (95%CI 1.127 to 137.487, P=0.040 )and atrial fibrillation (95%CI 1.177 to 23.378, P=0.030) wereindependent risk factors for longterm moderate or severe tricuspid regurgitation afteroperations.Conclusion TVP is necessary for most patients undergoing MVP for moderate or severe mitral regurgitation due to myxomatous degeneration who have coexistent mild functional tricuspid regurgitation, especially those patients with preoperative pulmonary artery pressure gt;30 mm Hg or atrial fibrillation.

    Release date:2016-08-30 05:57 Export PDF Favorites Scan
  • The Advance of Surgical Treatment of Ebstein Anomaly

    Abstract: Ebstein anomaly is a relatively rare congenital heart malformation which can affect heart function significantly. It may cause right heart failure, even whole heart failure and eventually death. In recent years, the surgery has made much progress in dealing with the abnormal valve, improving the right ventricle function and pretreatment of its related complications. However, because of its complexity and diversity in pathological anatomy and clinical manifestations, the disease has not got an “almighty standard” to treat all pathological anatomy types of the deformity, or asurgery strategy to solve the practical problems encountered in all clinic situations. Furthermore, the therapeutic effect is also unsatisfactory. This article will review the advance of treatment of Ebstein anomaly and prevention of its related complications.

    Release date:2016-08-30 06:02 Export PDF Favorites Scan
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