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《Chinese Journal of Cardiovascular Research》 2018-04
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The curative effect of surgical treatment for patients with severe rheumatic tricuspid valve regurgitation

ZHU Bo-wei;CHEN Kai-ming;LAI Feng-hua;Department of Cardiovascular Surgery,Gaozhou People's Hospital;  
Objective To evaluate the clinical effect of tricuspid plasty and tricuspid biological flap replacement on the treatment of tricuspid severe regurgitation in patients with rheumatic valvular heart disease.Methods he clinical data of 37 patients with tricuspid severe regurgitation have received tricuspid valvuloplasty or tricuspid biological flap replacement in our hospital was analyzed retrospectively. The patients were divided into two groups: Tricuspid plasty Group(forming group) 23 cases, tricuspid biological flap replacement Group(displacement group) 14 cases. There was no statistically significant difference in age, sex, heart function grading(NYHA)and tricuspid reflux grading in the two groups before operation(P0.05). The cardiac function grading, right atrium transverse diameter, right ventricular diastolic end diameter and tricuspid reflux area were recorded before, after and after 1 years. Results Early postoperative death in 3 cases(all were plasty group, among them, 2 cases died of low cardiac discharge, arrhythmia in 1 case). The remaining two groups were cured and discharged. The survival rates for the mid-term follow-up were: the forming group was 23/23(100%), displacement group 11/14(78.57%), and cardiac function grade were: Forming group heart function Ⅰ Grade 13 cases, Ⅱ grade 6 cases,Ⅲ grade 4 cases, displacement group heart function Ⅱ Grade 7 cases, Ⅲ Grade 3 cases, Ⅳ Grade 1 case.There were statistically significant differences in survival rate and cardiac functional grading in all groups during the mid-term follow-up(P0.05), and the forming group was superior to the displacement group. During the midterm follow-up, tricuspid reflux were Forming group 22 cases of mild reflux,moderate reflux in 1 case, displacement group mild reflux in 11 cases, with no statistically significant difference(P0.05). Conclusion Tricuspid biological flap replacement has higher early mortality and less postoperative cardiac function, and the degree of reflux after tricuspid plasty is similar to that of tricuspid replacement, and the postoperative cardiac function is good and survival rate is high,which is worthy of clinical popularization.
【CateGory Index】: R654.2
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