Haerten K, Seipel L, Herzer J, Loogen F, Bircks W
Z Kardiol. 1978 Oct;67(10):661-6.
Postoperative hemodynamic studies were conducted at rest and during exercise in 24 patients who, in addition to mitral and/or aortic valve surgery, had De Vega's tricuspid anuloplasty. To determine the degree of tricuspid insufficiency (TI), right atrial pressure (PRA) tracings, biplane right ventricular cineangiograms, and ultrasonic Doppler flow patterns were obtained. 20 patients had postoperative by a mild to moderate TI, but after operation the TI had improved by one or more degrees in 14 cases. In addition, a mild to moderate tricuspid stenosis with pressure gradients from 2.0 to 7.8 mm Hg were found in 12 patients. There was no significant change in mean right atrial pressure (PRA) with 8.0 +/- 4.5 mm Hg preoperatively and 7.5 +/- 3.5 mmHg postoperatively at rest. During exercise PRA rose to 17.0 +/- 6.5 mmHg. This pressure increase is in part due to the persistent elevation of left atrial and pulmonary artery pressure, in part to the TI and the tricuspid stenosis. De Vega's anuloplasty does not answer the tricuspid challenge, since the results are unpredictable.
对24例患者进行了术后血流动力学研究,这些患者除接受二尖瓣和/或主动脉瓣手术外,还进行了德维加三尖瓣环成形术,研究在静息和运动状态下进行。为了确定三尖瓣关闭不全(TI)的程度,获取了右心房压力(PRA)描记图、双平面右心室心血管造影以及超声多普勒血流图。20例患者术后存在轻度至中度TI,但术后14例患者的TI改善了一个或多个等级。此外,12例患者发现存在轻度至中度三尖瓣狭窄,压力阶差为2.0至7.8 mmHg。静息时,平均右心房压力(PRA)术前为8.0±4.5 mmHg,术后为7.5±3.5 mmHg,无显著变化。运动时,PRA升至17.0±6.5 mmHg。这种压力升高部分归因于左心房和肺动脉压力持续升高,部分归因于TI和三尖瓣狭窄。德维加环成形术无法应对三尖瓣的挑战,因为结果不可预测。