Ozaki T, Kondoh J, Sohma T, Adachi R, Kurata H, Imoto K, Kajiwara H, Tobe M, Hoshino K, Matsumoto A
First Department of Surgery, Yokohama City University, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1990 Aug;38(8):1248-54.
From 1985 to 1987, we examined relationship between the lesion of tricuspid valve and right ventricular function in 31 patients (male: 9, female: 22) with mitral valve disease. The median age at operation was 52 years (range 37-69 years). Group I consisted of 17 patients (MS: 10, MSR: 5, MR: 2) accompanied with tricuspid regurgitation (TR) and Group II 14 patients (MS: 12, MSR: 2) without TR. In all cases of Group I tricuspid annuloplasty (TAP) were performed correctly. De Vega methods were done in 12 cases and Carpentier rings were used in 5 cases. Cardiac catheterization was done before and after operation. And right ventricular volume was measured by right ventricular angiography. In both groups pulmonary capillary wedge pressure, pulmonary artery pressure and cardiac index were improved postoperatively. Pulmonary artery resistance (PAR) and total pulmonary resistance (TPR) in Group I were significantly higher before operation but there were no difference between two groups postoperatively. Right ventricular end-diastolic volume index (RVEDVI) and right ventricular end-systolic volume index (RVESVI) in Group I were significantly improved postoperatively, but in Group II these were within normal range both pre- and postoperatively. Preoperative PAR was correlated inversely with postoperative right ventricular ejection fraction (RVEF). It means that patients with severe pulmonary vascular lesion had postoperative lower right ventricular function. In both groups, RVESVI was in inverse correlation with RVEF pre- and postoperatively. In both groups, there was an inverse correlation between the per cent change of RVESVI and that of RVEF. This means that RVESVI influenced right ventricular pump function.
1985年至1987年期间，我们研究了31例二尖瓣疾病患者（男性9例，女性22例）三尖瓣病变与右心室功能之间的关系。手术时的中位年龄为52岁（范围37 - 69岁）。第一组由17例伴有三尖瓣反流（TR）的患者组成（二尖瓣狭窄：10例，二尖瓣狭窄合并反流：5例，二尖瓣反流：2例），第二组由14例无TR的患者组成（二尖瓣狭窄：12例，二尖瓣狭窄合并反流：2例）。在第一组的所有病例中，均正确进行了三尖瓣环成形术（TAP）。12例采用德维加法，5例使用卡彭蒂埃环。术前和术后均进行了心导管检查。通过右心室造影测量右心室容积。两组患者术后肺毛细血管楔压、肺动脉压和心脏指数均有所改善。第一组术前肺动脉阻力（PAR）和总肺阻力（TPR）显著更高，但两组术后无差异。第一组术后右心室舒张末期容积指数（RVEDVI）和右心室收缩末期容积指数（RVESVI）显著改善，但第二组术前和术后均在正常范围内。术前PAR与术后右心室射血分数（RVEF）呈负相关。这意味着严重肺血管病变的患者术后右心室功能较低。两组患者术前和术后RVESVI与RVEF均呈负相关。两组患者RVESVI的变化百分比与RVEF的变化百分比之间均呈负相关。这意味着RVESVI影响右心室泵功能。
