Xu Xu-Dong, Liu Su-Xuan, Bai Yuan, Zhang Min, Zhao Xian-Xian, Qin Yong-Wen
Department of Cardiology, Changhai Hospital, Second Military Medical University, 168 Changhai Road, Shanghai, 200433, People's Republic of China.
Department of Ultrasound Diagnosis, Changhai Hospital, Second Military Medical University, Shanghai, 200433, People's Republic of China.
Heart Vessels. 2015 Sep;30(5):611-7. doi: 10.1007/s00380-014-0531-6. Epub 2014 Jun 20.
As a common concomitant performance and the most frequent complications of transcatheter perimembranous ventricular septal defect (VSD) closure, tricuspid regurgitation (TR) has rarely been concerned. From January 2008 to December 2012, a total of 70 patients (men: 33, women: 37; mean age: 30.0 ± 17.1 years) with at least mild TR before VSD closure were examined in 508 consecutive congenital perimembranous VSD patients to investigate the outcomes of TR. After VSD closure, the jet area decreased from 3.4 ± 2.5 to 1.2 ± 2.5 cm(2) (p < 0.001); however, no significant decrease was found in 3 patients (mean age 59.7 ± 2.5 years) with severe TR (12.0 ± 1.2 versus 11.2 ± 3.2 cm(2), p = 0.668). Compared to the early outcome after VSD closure, the jet area detected by TTE at 6-month follow-up had further decreased (1.2 ± 2.5 versus 0.9 ± 2.2 cm(2), p < 0.001). In 6 patients, a slight residual shunt was detected immediately after VSD closure and diminished in 3 patients at 6-month follow-up. The hemolysis occurred in one of these six patients and recovered after 3 days. In conclusion, functional TR was ameliorated after percutaneous VSD closure, although persistent abundant TR was common in patients with severe TR before procedure.
作为经导管膜周部室间隔缺损(VSD)封堵术常见的伴随表现及最常见的并发症,三尖瓣反流(TR)很少受到关注。2008年1月至2012年12月,在508例连续性先天性膜周部VSD患者中,对70例(男性33例,女性37例;平均年龄30.0±17.1岁)在VSD封堵术前至少存在轻度TR的患者进行检查,以研究TR的转归。VSD封堵术后,反流束面积从3.4±2.5降至1.2±2.5cm²(p<0.001);然而,3例(平均年龄59.7±2.5岁)重度TR患者(反流束面积从12.0±1.2降至11.2±3.2cm²,p=0.668)未见显著下降。与VSD封堵术后早期结果相比,随访6个月时经胸超声心动图(TTE)检测到的反流束面积进一步减小(1.2±2.5与0.9±2.2cm²,p<0.001)。6例患者在VSD封堵术后即刻检测到轻微残余分流,其中3例在随访6个月时分流消失。这6例患者中有1例发生溶血,3天后恢复。总之,经皮VSD封堵术后功能性TR有所改善,尽管术前重度TR患者中持续性大量TR较为常见。