Peltola T, Lepojärvi M, Ikäheimo M, Kärkölä P
Department of Cardiothoracic Surgery, Oulu University Hospital, Finland.
Ann Chir Gynaecol. 1996;85(1):40-3.
A total of 337 patients underwent a mitral or combined mitral and aortic valve operation at the Oulu University Hospital between 1986 and 1992. Of these, 30 (8.9%) patients had De Vega's semicircular annuloplasty performed because of tricuspid regurgitation (TR) which was considered functional in nature. There were five (16.6%) early and seven (23.3%) late deaths during the follow-up period of 10 to 71 months. The preoperative mean New York Heart Association (NYHA) functional class was 3.4, and at follow-up 13 (76.5%) of the survivors were in NYHA CLass I or II. The actuarial survival rate was 37.6% at five years. All the survivors were evaluated echocardiographically and the TR was considered mild in 56.3%, moderate in 25.0% and severe in 18.7% of the cases. Tricuspid annuloplasty using De Vega's semicircular suture technique is a simple and effective procedure in patients with mild to moderate regurgitation. In patients with massive regurgitation, which is usually associated with a massively dilated tricuspid annulus and pulmonary hypertension, annuloplasty should be reinforced using a ring technique. Tricuspid valve replacement is hardly ever needed in the treatment of functional tricuspid regurgitation.
1986年至1992年间，共有337例患者在奥卢大学医院接受了二尖瓣或二尖瓣与主动脉瓣联合手术。其中，30例（8.9%）患者因功能性三尖瓣反流（TR）接受了德维加半圆形瓣环成形术。在10至71个月的随访期内，有5例（16.6%）早期死亡和7例（23.3%）晚期死亡。术前纽约心脏协会（NYHA）功能分级平均为3.4级，随访时13例（76.5%）幸存者为NYHA I级或II级。五年时的精算生存率为37.6%。对所有幸存者进行了超声心动图评估，56.3%的病例中TR被认为是轻度的，25.0%为中度，18.7%为重度。对于轻至中度反流的患者，采用德维加半圆形缝合技术进行三尖瓣瓣环成形术是一种简单有效的方法。对于大量反流的患者，通常伴有三尖瓣环大量扩张和肺动脉高压，应采用环技术加强瓣环成形术。在功能性三尖瓣反流的治疗中，几乎不需要进行三尖瓣置换。
