关键词: 三尖瓣关闭不全, 三尖瓣成形术, 三尖瓣置换术

Abstract: Abstract Background: Functional tricuspid regurgitation (TR) can often be observed in patients with rheumatic mitral valve disease, including those who undergo the operation for the first or second time. The aim of this study was to analyze TR in a group of patients who underwent successful mitral valve surgery. Methods and Results: 45 patients with TR after mitral valve replacement were involved in this study. 43 patients (95.6%) had right heart failure symptoms (edema of double lower extremity, ascites, hepatic congestion, etc.). 40 patients (88.9%) had atrial fibrillation. Twenty-six patients (57.8%) were in New York Heart Association (NYHA) functional class III, and 19 (42.9%) in class IV. Prior operations included: 41 for mechanical mitral valve replacement (91.1%), 4 for bioprosthetic mitral valve replacement (8.9%), and 7 for tricuspid annuloplasty (15.6%). All the patients received medicine to improve the heart function. The tricuspid valves were repaired with Kay's (7 cases, 15.6%) or De Vega technique (4 cases, 8.9%). Tricuspid valve replacements were performed in 34 cases (75.6%). 1 patient died (2.2%). Postoperative low cardiac output syndromes (LCOS) were observed in 5 patients and treated effectively. Postoperative echocardiography showed obvious reduction of right atrium and ventricle. Comparing with the preoperative data (33.7±6.2mm), the anteroposterior diameter of right ventricle decreased to 23-41mm (25.5 ±7.1mm) (P<0. 05). Conclusions: If TR occurs or progresses late after valve surgery, annuloplasty or replacement to tricuspid valve may be required and could get a satisfied outcome even if it could carries a high operative risk.

Key words: tricuspid regurgitation, tricuspid annuloplasty, tricuspid valve replacement