Pedersen Thais A L, Wierup Per, Pedersen Lia Mendes, Egeblad Henrik, Hjortdal Vibeke E
Hjerte-lunge-karkirurgisk Afdeling T, Arhus Universitetshospital, Skejby, DK-8200 Arhus N, Denmark.
Ugeskr Laeger. 2010 Feb 1;172(5):359-63.
Tricuspid valve regurgitation (TVR) is often secondary to left-sided or congenital heart disease (CHD). Surgical correction of TVR is indicated when the primary abnormalities require operation.
Retrospective analysis of all 50 patients (mean age: 65 years (range: 24-83), 27 males, 23 females) operated with tricuspid valve annuloplasty (TVA) in our hospital from 2000 to 2007. TVA took place concomitantly with operation for left heart disease (n = 39, 78%) or CHD (n = 11, 22%).
Preoperatively, TVR was severe in 40, moderate in six and mild in four cases. Thirty-four had annulus dilation > 2 cm/m(2) body surface area. Half of the patients were in New York Heart Association (NYHA) class III or IV. Postoperatively, TVR was severe in two cases, moderate in one, mild in 25 and absent in 18, and 95% of patients followed up were in NYHA I or II. There were five (10%) early and two (4%) late deaths. Temporary arrhythmias requiring medical treatment occurred in 35 cases, but eight required permanent pacemaker. No tricuspid valve reoperations were performed.
The combination of correction of primary heart abnormalities and TVA is associated with high perioperative mortality. In survivors, postoperative clinical improvement is common, in all probability this is mainly due to the correction of the primary disease. TVA reduces TVR, but its precise contribution to clinical improvement and prognosis remains unknown.
三尖瓣反流（TVR）通常继发于左心疾病或先天性心脏病（CHD）。当原发性异常需要手术时，就需要对TVR进行手术矫正。
回顾性分析了我院2000年至2007年期间接受三尖瓣环成形术（TVA）的所有50例患者（平均年龄：65岁（范围：24 - 83岁），男性27例，女性23例）。TVA与左心疾病手术（n = 39，78%）或CHD手术（n = 11，22%）同时进行。
术前，40例患者TVR严重，6例中度，4例轻度。34例患者瓣环扩张>2 cm/m²体表面积。一半患者为纽约心脏协会（NYHA）III或IV级。术后，2例患者TVR严重，1例中度，25例轻度，18例无反流，95%的随访患者为NYHA I或II级。有5例（10%）早期死亡和2例（4%）晚期死亡。35例患者发生需要药物治疗的临时心律失常，但8例需要永久起搏器。未进行三尖瓣再次手术。
原发性心脏异常矫正与TVA联合手术围手术期死亡率较高。在幸存者中，术后临床改善常见，很可能这主要是由于原发性疾病得到矫正。TVA可降低TVR，但其对临床改善和预后的确切贡献尚不清楚。
