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双孔三尖瓣的临床经验。

The clinical experience of double-orifice tricuspid valve.

机构信息

Depatment of Cardiothoracic Surgery, Second Xiangya Hospital of Central South Univercity, Changsha, Hunan 410011, PR China.

出版信息

Heart Lung Circ. 2013 Mar;22(3):229-30. doi: 10.1016/j.hlc.2012.06.019. Epub 2012 Aug 11.

Abstract

BACKGROUND AND AIM OF THE STUDY

Double-orifice tricuspid valve (DOTV) is an extremely rare congenital anomaly. By analysing the feature of its diagnosis and surgical treatment, we want to summarise the clinical experience of treating DOTV.

MATERIALS AND METHODS

Review two cases of DOTV treated by us between August 2009 and December 2011. One case was diagnosed as partial atrioventricular septum defect, and the other was tetralogy of Fallot. The defects were both identified during the operation for other congenital cardiac malformations and both accessory orifices were normal. But one of them was sutured because of its possible effect in future.

RESULTS

Cardiac colour Doppler echocardiogram was made at three to five days after operation and all results were normal. No operative complication or late deaths occurred. The time of follow-up were one month, three months, six months, one year and two years after operation, and all examinations were normal.

CONCLUSIONS

The accessory orifice of DOTV patients has its own independent chordae tendinea and mastoid muscle. So the gap of tricuspid valve should be excluded and the classification should be amended according to it. It should be surgically treated, when there is of dysfunction with it or potential harmful effect in sequent treatment.

摘要

背景与研究目的

双孔三尖瓣(DOTV)是一种极为罕见的先天性异常。通过分析其诊断和手术治疗的特点,我们总结了治疗 DOTV 的临床经验。

材料与方法

回顾 2009 年 8 月至 2011 年 12 月我们治疗的 2 例 DOTV 患者。1 例被诊断为部分房室间隔缺损,另 1 例为法洛四联症。这两个病例均在治疗其他先天性心脏畸形的手术中发现存在额外瓣口,且两个副瓣口均正常。但因为可能对未来造成影响,我们对其中一个副瓣口进行了缝合。

结果

术后 3 至 5 天行心脏彩色多普勒超声心动图检查,结果均正常。无手术并发症或晚期死亡。术后随访时间为 1 个月、3 个月、6 个月、1 年和 2 年,所有检查均正常。

结论

DOTV 患者的副瓣口有其独立的腱索和乳突肌。因此,应该排除三尖瓣瓣口的间隙,并根据其进行分类修正。当存在功能障碍或对后续治疗有潜在有害影响时,应进行手术治疗。

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