Spitzer S, Schwerdt H, Vogel W, Stoll H P, Fröhlig G, Volkmer I, Kalweit G, Schieffer H
Innere Medizin III (Kardiologie), Universitätskliniken des Saarlandes, Homburg-Saar.
Z Kardiol. 1990 Nov;79(11):797-801.
The implantation of valvular prostheses in tricuspid position is problematic due to the slow blood flow in the low-pressure system with the risk of valvular thromboses. Today there are prostheses with supportable low transvalvular gradients; nevertheless, the risk of valvular thromboses is, in spite of anticoagulation, increased by using mechanical prostheses in tricuspid position. We report on a 51-year-old woman in whom a dysfunction of the Starr Edwards ball prosthesis 15 years after its implantation in the tricuspid position was diagnosed. The prosthesis, which was unable to function due to connective tissue proliferation, was replaced by a St. Jude Medical prosthetic valve, which also presented a disturbed function a few days after the implantation. Because of a suspected valve thrombosis the patient was treated with rt-PA-lysis which proved to be ineffective. Thus it was inevitable to implant a third tricuspid valve; this time a bioprosthesis was used.
由于低压系统中血流缓慢且存在瓣膜血栓形成的风险，三尖瓣位置的人工瓣膜植入存在问题。如今有可支持低跨瓣膜梯度的人工瓣膜；然而，尽管进行了抗凝治疗，但在三尖瓣位置使用机械人工瓣膜仍会增加瓣膜血栓形成的风险。我们报告了一名51岁女性，其在三尖瓣位置植入Starr Edwards球瓣假体15年后被诊断出功能障碍。该假体因结缔组织增生而无法正常工作，被圣犹达医疗公司的人工瓣膜替换，但植入几天后该瓣膜功能也出现异常。由于怀疑瓣膜血栓形成，患者接受了rt-PA溶栓治疗，但证明无效。因此不可避免地要植入第三个三尖瓣；这次使用的是生物假体。
