Comparison Of The Curative Effect Of Different Tricuspid Valvuloplasty In The Treatment Of Moderate Functional Tricuspid Regurgitation

Objective: The study aims to compare and analyze the effects of the treatment of moderately functional tricuspid regurgitation with different intraoperative technique.The purpose of this study was to compare and analyze the efficacy of different intraoperative treatments in the treatment of moderate functional tricuspid regurgitation.Methods: A total of 43 patients with tricuspid valve insufficiency admitted to the study who were diagnosed by Department of Cardiac Surgery of the First Affiliated Hospital of Guangxi Medical University from January 2017 to August2020.According to different methods of operation,the patients were divided into suture group(n = 20)and upper ring group(n = 23).The general condition,complications,NYHA cardiac function grade,right atrial diameter,right ventricular diameter and tricuspid reverse flow of preoperative,intraoperative and postoperative were calculated respectively.The surgical efficacy of different treatment methods was compared and analyzed by software SPSS19.0.Results: After comparing the preoperative data and the aortic block time,extracorporeal circulation time,ventilator use time,intensive care unit stay time and postoperative hospital stay of the two groups of patients,we found that there was no significant difference in baseline data between the two groups which were comparable.In terms of complications,7 cases of postoperative complications occurred in the suture group,including 5 cases of pulmonary infection,1 case of postoperative acute renal injury,0 cases of new cerebral infarction,and 1 case of low cardiac output.There were 8 cases of postoperative complications occurred in the upper ring group.Among them,6 cases were pulmonary infection,1 case was postoperative acute renal injury,0 case was new cerebral infarction,1 case was low cardiac output.There was no significant difference between the two groups in terms of postoperative complications(P>0.05).All patients were reexamined before discharge(approximately 1 week after operation)with cardiac color ultrasound.And no difference was found in the comparison of the right atrium transverse diameter,right ventricular diameter and cardiac function classification.Both groups of surgical treatment methods can improve cardiac function classification,right atrial transverse diameter,right ventricular diameter,and tricuspid regurgitation flow(P<0.05).We observed that the tricuspid regurgitation flow in the upper ring group was significantly less than that in the suture group(P < 0.05).three months after surgery,we found that the right atrial diameter,right ventricular diameter and cardiac function classification were not different in the two groups.It is worth mentioning that the tricuspid regurgitation volume of the upper ring group remains less than that of the suture group(P<0.05).In the retrospection of the included cases,no moderate or severe tricuspid regurgitation was observed in any of the patients treated by any of the above surgical methods,except for 1case in the suture group who developed massive tricuspid regurgitation with obvious heart failure symptoms which was symptomatic and improved.Conclusions:1 、 Tricuspid valvuloplasty can effectively treat functional tricuspid regurgitation.2 、 Artificial annuloplasty is significantly better than suture plasty in improving the clinical effect of functional tricuspid regurgitation.