Correlational Research Of Perimembranous Ventricular Septal Defect Interventional Therapy On The Tricuspid

Objective：It is aimed to study and analyze the influence on tricuspid regurgitation withnterventional therapy of ventricular septal defect，and to discuss the relative factorsContributing to the tricuspid regurgitation。Method:From September2011to March2013,195patients with simple membranedefect underwent successfully transcatheter closure of PMVSD in our hospital. Onehundred ninety-five patients included18patients with film aneurysm。 All thepatients had transthoracic echocardiography before the operation. The patients wentthrough transthoracic echocardiography respectively at three days later, one monthlater, three months later, half a year later, one year later and two year later after theoperation. The Impacts of tricuspid and Correlational factors on tricuspidregurgitation were analyzed through observing tricuspid regurgitation before and afterthe surgery.Results:1. Thirty-three patients in195patients with ventricular septal defect hadtricuspid regurgitation through transthoracic echocardiography one day before theoperation. Twenty-eight patients had mild tricuspid regurgitation and five patients hadmoderate tricuspid regurgitation before the surgery. Two years after transcatheterclosure of perimembranous VSD, tricuspid regurgitation of16patients constant(about48.5%),1patients with mild tricuspid regurgitation had been relieved, andtricuspid regurgitation of16patients returned to normal (about48.5%).2. After ventricular septal defect closer,47patients had tricuspid regurgitation(about24.1%)，inclued38patients had tricuspid Slightly a little regurgitation(19.4%)and9patients had tricuspid mild regurgitation(4.6%).During the2-year follow-up,tricuspid regurgitation of one patient with tricuspid mild regurgitation was severe dueto interventional therapy in six month after surgery, tricuspid regurgitation of27patients constant (about57.4%), and tricuspid regurgitation of19patients with tricuspid Slightly a little regurgitation returned to normal (about40.4%).3. The related factors contributing to the tricuspid regurgitation in47patientsafter transcatheter closure of perimembranous VSD were statistically analyzed. Theresults showed that the tricuspid regurgitation was not only mainly related to theoperation, but also related to many other various factors, including ages, the size ofVSD, the size and tipe of occluder as well as numbers to the operation. However, ithas no significant correlation with membrane of tumor which occurred beforetranscatheter closure of perimembranous VSD、 types of occluder, and the size ofenter the sheath.Conclusion：1. Ventricular septal defect occlusion is a double-edged sword for tricuspidregurgitation. Tricuspid regurgitation can be relieved after ventricular septal defectsurgery. However, the surgery can cause the occurrence of tricuspid regurgitation.2. It demostrated that the tricuspid regurgitation after the therapy was not onlymainly related to improper operation, but also related to many other various factors,including ages, the size of VSD, the size and tipe of occluder as well as numbers tothe operation. However, it has no significant correlation with membrane of tumorwhich occurred before transcatheter closure of perimembranous VSD、 types ofoccluder, and the size of enter the sheath.