Bilen Çağatay, Akkaya Gökmen, Tuncer Osman Nuri, Atay Yüksel
Department of Cardiovascular Surgery, Ege University School of Medicine, Izmir, Turkey.
Acta Cardiol Sin. 2020 Jul;36(4):360-366. doi: 10.6515/ACS.202007_36(4).20191012A.
The aim of this study was to investigate the efficiency of tricuspid valve detachment (TVD) during the surgical treatment of perimembranous ventricular septal defects (VSDs) and to compare the early and mid-term results to patients without TVD in terms of tricuspid insufficiency.
A total of 170 patients who had undergone surgical closure of perimembranous VSDs between November 2012 and January 2019 were included in this study, of whom 50 had an additional TVD procedure during the surgery. All patients were examined by transthoracic echocardiography before and after the operation with regular intervals, and the tricuspid valve function was then evaluated.
There was no significant difference between subgroups with an unchanging degree of TVR, however, the result was also similar among those who had a decreased degree of TVR at any level (p = 0.271, p = 0.451). At the end of the study, all patients were in New York Heart Association class I.
We suggest that, in appropriate patients, VSD closure can be safely performed with an additional TVD application through an incision of the septal leaflet of the tricuspid valve without impairing the valve function or reducing the growth potential of the valve at midterm follow-up.
本研究的目的是探讨在膜周部室间隔缺损（VSD）手术治疗期间三尖瓣分离术（TVD）的有效性，并就三尖瓣关闭不全方面比较有TVD和无TVD患者的早期和中期结果。
本研究纳入了2012年11月至2019年1月期间接受膜周部VSD手术闭合的170例患者，其中50例在手术期间还进行了TVD手术。所有患者在术前和术后定期接受经胸超声心动图检查，然后评估三尖瓣功能。
三尖瓣反流程度不变的亚组之间无显著差异，然而，在任何水平三尖瓣反流程度降低的患者中结果也相似（p = 0.271，p = 0.451）。在研究结束时，所有患者的心功能均为纽约心脏协会I级。
我们认为，对于合适的患者，通过三尖瓣隔叶切口附加TVD进行VSD闭合术可安全实施，且在中期随访中不损害瓣膜功能或降低瓣膜生长潜力。
