Lafçı Gökhan, Çiçek Ömer Faruk, Lafçı Ayşe, Esenboğa Kerim, Günertem Eren, Kadiroğulları Ersin, Çiçek Mustafa Cüneyt, Diken Adem İlkay, Çağlı Kerim
Department of Cardiovascular Surgery, Türkiye Yüksek İhtisas Training and Research Hospital, Ankara, Turkey.
Department of Cardiovascular Surgery, Selçuk University School of Medicine, Konya, Turkey.
Turk Gogus Kalp Damar Cerrahisi Derg. 2019 Jun 17;27(3):286-293. doi: 10.5606/tgkdc.dergisi.2019.17474. eCollection 2019 Jul.
This study aims to compare three different tricuspid annuloplasty techniques using suture, ring, and band.
Between January 2010 and December 2015, a total of 231 consecutive patients (78 males, 153 females; mean age 50.3±15.9 years; range, 34 to 66 years) who underwent tricuspid valve annuloplasty using three different techniques were retrospectively analyzed. Tricuspid valve r epair w as p erformed w ith d e Vega a nnuloplasty t echnique (n=62, 26.8%), flexible ring (n=76, 32.9%) or Teflon strip (n=93, 40.3%). Postoperative data including vital signs, echocardiographic reports, functional status, and the rate of re-do surgeries were recorded.
Cardiopulmonary bypass times were statistically significantly shorter in the de Vega annuloplasty group (p<0.001). There was no significant difference among the groups in terms of the in-hospital mortality. Late postoperative tricuspid regurgitation grades, systolic pulmonary artery pressure, and right atrial diameters showed significant improvements, compared to baseline, in ring and strip annuloplasty groups.
Our study results demonstrate that suture-based approaches should be avoided. Instead of performing routine tricuspid ring annuloplasty, Teflon strip annuloplasty may be considered an alternative method in most cases, particularly due to controversy in selection of true ring size and high cost of this surgical material in the real-life setting.
本研究旨在比较使用缝线、环和带的三种不同三尖瓣成形术技术。
回顾性分析2010年1月至2015年12月期间连续接受三种不同技术三尖瓣成形术的231例患者(78例男性,153例女性;平均年龄50.3±15.9岁;范围34至66岁)。采用德维加成形术技术(n=62,26.8%)、柔性环(n=76,32.9%)或聚四氟乙烯条(n=93,40.3%)进行三尖瓣修复。记录术后数据,包括生命体征、超声心动图报告、功能状态和再次手术率。
德维加成形术组体外循环时间在统计学上显著缩短(p<0.001)。各组间院内死亡率无显著差异。与基线相比,环和条成形术组术后晚期三尖瓣反流分级、收缩期肺动脉压和右心房直径有显著改善。
我们的研究结果表明应避免基于缝线的方法。在大多数情况下,聚四氟乙烯条成形术可被视为常规三尖瓣环成形术的替代方法,特别是由于在实际临床中选择合适环尺寸存在争议且该手术材料成本较高。