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法洛四联症矫治术后行三尖瓣成形术联合肺动脉瓣置换术。

Repair of tricuspid valve with pulmonary valve replacement in repaired tetralogy of fallot.

机构信息

a Department of Pediatrics, Samsung Medical Center , Sungkyunkwan University School of Medicine , Seoul , Korea.

b Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center , Sungkyunkwan University School of Medicine , Seoul , Korea.

出版信息

Scand Cardiovasc J. 2019 Jun;53(3):148-152. doi: 10.1080/14017431.2019.1610572. Epub 2019 May 15.

DOI:10.1080/14017431.2019.1610572
PMID:31017007
Abstract

: We aimed to investigate the outcome of tricuspid valve repair (TVR) performed concomitantly with pulmonary valve replacement in repaired tetralogy of Fallot (TOF) patients. : This retrospective study included all patients who underwent pulmonary vale replacement from 2000 to 2016 after TOF correction. TVR patient data were compared to those of patients who underwent pulmonary vale replacement alone. : Thirty-eight patients were enrolled. The degree of tricuspid regurgitation was significantly decreased after operation in the TVR group. Tricuspid valve annulus and annuloectasia before operation did not vary between groups (21.1 ± 6.3 and 41.4% in no TVR 21.3 ± 4.8 and 52.6% in TVR). However pre-operative right ventricular volumes were larger in the TVR group. Normal tricuspid valve coaptation (body to body) was observed less frequently in the TVR group than in the other group (52.6% 93.1%, < .001). Pre-operative tricuspid regurgitation had a linear correlation with right ventricular volume, but not with tricuspid annulus size. : Tricuspid annulus diameter decreased significantly regardless of TVR. Abnormal coaptations were observed more in patients group and the degree of pre-operative tricuspid regurgitation was linearly correlated with right ventricular volume rather than tricuspid annulus size.

摘要

: 本研究旨在探讨同期行三尖瓣修复术(TVR)对法洛四联症(TOF)患者行肺动脉瓣置换术(PVR)的治疗效果。 : 本回顾性研究纳入了 2000 年至 2016 年因 TOF 矫正而接受 PVR 的所有患者。将 TVR 患者的数据与仅接受 PVR 患者的数据进行比较。 : 共纳入 38 例患者。TVR 组患者术后三尖瓣反流程度明显降低。术前 TVR 组与非 TVR 组的三尖瓣环及瓣环扩张程度无差异(分别为 21.1±6.3%和 41.4%,21.3±4.8%和 52.6%)。然而,TVR 组术前右心室容积较大。TVR 组患者的正常三尖瓣对合(体对体)较非 TVR 组少见(52.6% 93.1%,<.001)。术前三尖瓣反流与右心室容积呈线性相关,与三尖瓣环大小无关。 : 无论是否行 TVR,三尖瓣环直径均显著减小。异常对合在 TVR 组更常见,且术前三尖瓣反流程度与右心室容积呈线性相关,而与三尖瓣环大小无关。

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