Morishita Y, Arikawa K, Toyohira H, Shimokawa S, Umebayashi Y, Saigenji H, Moriyama Y, Taira A
Second Department of Surgery, Kagoshima University School of Medicine, Japan.
Nihon Geka Gakkai Zasshi. 1991 Jan;92(1):82-8.
The best means of managing tricuspid regurgitation associated with acquired valvular disease is still controversial. During the period from 1978 to 1988, 111 patients who had tricuspid regurgitation along with associated valvular dysfunction were treated in Kagoshima University Hospital. Patients with moderate to severe regurgitation underwent annuloplasty in 61 (Carpentier's in 39, DeVega's in 20, and Kay's method in 2) and valve replacement in 8. Forty-two patients were treated conservatively on the tricuspid valve because of mild regurgitation. We found the results to be less satisfactory with a high incidence of postoperative deaths and residual tricuspid regurgatation in the group treated by annuloplasty with a Carpentier ring than in the other two groups of annuloplasty or in the group of valve replacement. We conclude the modified DeVega's method is the first choice for annuloplasty in patients with mild to moderate regurgitation, and we believe it appropriate to replace the valve in an increasing number of subjects which have severe regurgitation.
治疗与后天性瓣膜病相关的三尖瓣反流的最佳方法仍存在争议。1978年至1988年期间，鹿儿岛大学医院对111例伴有三尖瓣反流及相关瓣膜功能障碍的患者进行了治疗。61例中重度反流患者接受了瓣环成形术（39例采用Carpentier法，20例采用DeVega法，2例采用Kay法），8例接受了瓣膜置换术。42例因轻度反流对三尖瓣进行了保守治疗。我们发现，与其他两组瓣环成形术组或瓣膜置换术组相比，采用Carpentier环进行瓣环成形术治疗的患者术后死亡率和残余三尖瓣反流发生率较高，结果不太令人满意。我们得出结论，改良的DeVega法是轻至中度反流患者瓣环成形术的首选方法，并且我们认为对于越来越多的重度反流患者进行瓣膜置换是合适的。
