Department of Cardiovascular Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan.
Department of Cardiology, Osaka City University Graduate School of Medicine, Osaka, Japan.
Interact Cardiovasc Thorac Surg. 2022 Jul 9;35(2). doi: 10.1093/icvts/ivac145.
The morphology of the tricuspid valve (TV), particularly valves with two posterior leaflets, is attracting attention. The present study was performed to investigate the usefulness of three-dimensional transoesophageal echocardiographic data for morphological evaluation of the TV .
Sixty patients underwent morphological evaluation of the TV by preoperative transoesophageal echocardiography followed by TV repair with median sternotomy, and each leaflet was measured intraoperatively. We analysed the TV morphology in 51 patients whose preoperative echocardiographic findings were consistent with intraoperative findings.
The mid-systolic echo data, which included the annulus diameter of each leaflet, were correlated with the intraoperative evaluation findings compared with those in the mid-diastole. The annulus and area of the posterior leaflet were larger in patients with two than one posterior leaflet valve (42.4 ± 13.5 vs 30.7 ± 9.1 mm, P < 0.001 and 327 ± 185 vs 208 ± 77 mm2, P = 0.006, respectively). In the severe tricuspid regurgitation patients, the annulus of the posterior leaflet was larger and the annulus of the anterior leaflet was smaller in patients with two than one posterior leaflet valve [posterior: 48 mm [95% confidence interval (CI), 41-54 mm] vs 36 mm (95% CI, 27-45 mm), respectively; P = 0.043 and anterior: 38 mm (95% CI, 33-42 mm) vs 46 mm (95% CI, 40-52 mm), respectively; P = 0.025].
Patients who had a TV with two posterior leaflets had a larger annulus and area of the posterior leaflets. Preoperative three-dimensional transoesophageal echocardiography is useful for the morphological evaluation of the TV.
三尖瓣（TV）的形态，特别是具有两个后瓣的瓣膜，正引起关注。本研究旨在探讨三维经食管超声心动图数据在 TV 形态评估中的作用。
60 例患者接受了术前经食管超声心动图检查，然后通过正中胸骨切开术进行 TV 修复，并在术中对每个瓣叶进行测量。我们分析了 51 例术前超声心动图结果与术中结果一致的患者的 TV 形态。
与舒张中期相比，包括每个瓣叶瓣环直径的收缩中期回声数据与术中评估结果相关。具有两个后瓣的患者瓣环和后瓣面积大于具有一个后瓣的患者（42.4±13.5 毫米 vs 30.7±9.1 毫米，P<0.001 和 327±185 毫米 2 vs 208±77 毫米 2，P=0.006）。在严重三尖瓣反流患者中，具有两个后瓣的患者后瓣瓣环较大，前瓣瓣环较小[后瓣：48 毫米（95%置信区间[CI]，41-54 毫米） vs 36 毫米（95% CI，27-45 毫米），分别；P=0.043 和前瓣：38 毫米（95% CI，33-42 毫米） vs 46 毫米（95% CI，40-52 毫米），分别；P=0.025]。
具有两个后瓣的 TV 患者瓣环和后瓣面积较大。术前三维经食管超声心动图对 TV 的形态评估有用。
