Zhang Jing, Ma Wei-Guo, Pan Shi-Wei
Department of Cardiovascular Surgery, Fu Wai Hospital and Cardiovascular Institute, Chinese Academy of Medical Sciences, Beijing, China.
J Card Surg. 2011 Jul;26(4):425-8. doi: 10.1111/j.1540-8191.2011.01254.x. Epub 2011 Apr 19.
Double-orifice tricuspid valve (DOTV) is a very rare cardiac malformation. We sought to describe our experience with surgical management of this defect in three cases.
Between September 2008 and October 2010, three patients (one male, two females) with DOTV were treated at our institute. They were 62, 20, and 32 years of age, respectively. The diagnosis of DOTV was made during the operation for other congenital cardiac malformations including partial atrioventricular septum defect, tetralogy of Fallot, and Ebstein's anomaly. The DOTV was regurgitant in all (moderate in one case and mild in two cases) without stenosis. Surgical management included tricuspid valve annuloplasty in two cases and suture of the accessory orifice in one case. Associated malformations were simultaneously corrected.
Echocardiography after the surgery revealed good coaptation of the tricuspid valve with trivial regurgitation and no tricuspid stenosis. No operative complication or late deaths occurred. All three patients were asymptomatic on follow-up.
The occurrence of the DOTV is extremely rare and it is difficult to diagnose by echocardiography. It is always associated with other congenital cardiac malformations that determine patient outcome.
双孔三尖瓣(DOTV)是一种非常罕见的心脏畸形。我们试图描述三例该缺陷手术治疗的经验。
2008年9月至2010年10月,我院治疗了三例DOTV患者(1例男性,2例女性)。他们的年龄分别为62岁、20岁和32岁。DOTV的诊断是在因其他先天性心脏畸形(包括部分房室间隔缺损、法洛四联症和埃布斯坦畸形)进行手术时做出的。所有患者的DOTV均有反流(1例中度,2例轻度),无狭窄。手术治疗包括2例行三尖瓣环成形术,1例行副孔缝合术。同时矫正相关畸形。
术后超声心动图显示三尖瓣对合良好,仅有微量反流,无三尖瓣狭窄。未发生手术并发症或晚期死亡。所有三名患者在随访中均无症状。
DOTV的发生率极低,超声心动图难以诊断。它总是与其他先天性心脏畸形相关,这些畸形决定了患者的预后。