Department of Cardiovascular Sciences, IRCCS A. Gemelli University Polyclinic Foundation, Rome, Italy.
Department of Cardiovascular Sciences, IRCCS A. Gemelli University Polyclinic Foundation, Rome, Italy -
J Cardiovasc Surg (Torino). 2023 Aug;64(4):437-442. doi: 10.23736/S0021-9509.23.12565-1.
In patients undergoing mitral valve surgery, restrictive suture annuloplasty (De Vega) for less-than-severe functional tricuspid regurgitation has been proven to be safe and effective. The aim of this study is to determine whether the adjunct of the plication of the posterior tricuspid leaflet with the same running suture (bicuspidized De Vega or "De Kay") is equally safe and effective.
Single center, retrospective study on patients submitted to suture repair of the tricuspid valve during mitral valve surgery, with either conventional or De Kay, between January 2014 and December 2020. Comparison was based on degree of residual tricuspid valve regurgitation and right ventricular assessment at discharge.
Over the course of the study period, 255 patients undergoing mitral valve surgery had a dilated (>40 mm or >20 mm/m) tricuspid valve annulus, with less-than-severe tricuspid regurgitation. Conventional De Vega was employed in 166 patients (65.1%) and De Kay in the remaining 89 (34.9%). At discharge the adjunct of postero-septal commissure plication has similar outcomes to the classic De Vega repair. It seems to preserve right ventricular function.
De Kay repair guarantees the same tricuspidal regurgitation reduction as compared with conventional De Vega early after surgery.
在接受二尖瓣手术的患者中，对于轻-中度功能性三尖瓣反流，限制性缝线瓣环成形术（De Vega）已被证明是安全有效的。本研究旨在确定是否可以通过同样的连续缝线对后瓣叶进行折叠（双瓣化 De Vega 或“De Kay”）来增强其疗效。
对 2014 年 1 月至 2020 年 12 月间接受二尖瓣手术并进行三尖瓣缝合修复的患者进行单中心回顾性研究，采用传统的 De Vega 技术或双瓣化 De Vega 技术。通过比较出院时残余三尖瓣反流程度和右心室评估来进行评估。
在研究期间，255 例行二尖瓣手术的患者三尖瓣环扩张（>40mm 或>20mm/m），存在轻-中度三尖瓣反流。166 例（65.1%）患者采用传统的 De Vega 技术，其余 89 例（34.9%）患者采用 De Kay 技术。出院时，后-隔瓣交界折叠的附加术式与经典的 De Vega 修复术具有相似的效果。它似乎可以保留右心室功能。
与传统的 De Vega 修复术相比，De Kay 修复术在术后早期能达到相同的三尖瓣反流减少效果。
