Edwards MC3Ring Formed In The Treatment Of Moderate To Severe Tricuspid Regurgitation Application

Objective:We study the curative effect of tricuspid valve annuloplasty by Edwards MC3ring, through retrospective analysis of the prognosis after operations of67patients with tricuspid severe regurgitation.And we provide basis for treatment of tricuspid severe regurgitation.Methods:Tricuspid valve annuloplasty were performed using Edwards MC3ring on67patients who we collected from2011December to2012December in Tianjin chest hospital. At the same time, the operation combined mitral valve replacement(43cases), aortic valve replacement(1case), mitral valve and aortic valve replacement13cases), atrioseptopexy(10cases) and CABG(5cases).The operation was performed to treat protopathy first, and tricuspid valve annuloplasty were performed at last. The appropriate Edwards MC3ring was used by size of tricuspid valve. Edwards MC3ring was installed on the valve ring and interrupted mattress suture was used. Cardiac ultrasound was performed before and after the operation. The degree of reverse flow of tricuspid valve, sizes of atriums and ventricles, the pulmonary arterial pressure and left ventricular ejection fraction after1week and6month were compared.Results:After the operation, the echocardiography suggested that valvular regurgitation was significantly reduced and hepatomegaly, ascites, edema of lower extremities and other symptoms were improved after surgery.1weeks after the operation, heart ultrasound suggested:tricuspid regurgitation was significantly reduced, and there were mild regurgitation(66cases) and moderate regurgitation(1case).6month after operation, there were mild regurgitation(64cases) and moderate regurgitation(3case). Sizes of atriums and ventricles were significantly reduced. The right atrial diameter(57.21±11.80mm before operation) became44.92±4.51mm1week after operation and38.84±5.51mm6months after operation. The right ventricular diameter (23.51±7.71mm before operation) became18.93±4.20mm1week after operation, and then lowered to17.55±3.256months after operation. Pulmonary artery pressure (57.54±10.16mmHg before operation) became38.34±6.14mmHg1week after operation and35.26±6.14mmHg six months after operation. The differences were statistically significant (P<0.05). Ejection fraction was not improved1week after operation, but it was improved six months after operation(P<0.05).Conclusion:After the operation, valvular regurgitation of67patients was significantly reduced. The sizes of right ventricle and right atrium were reduced and pulmonary arterial pressure decreased. There were1case with tricuspid valve moderate regurgitation which did not go further after6months, because of fold and remodeling of valve ring by Edwards MC3ring.