| ObjectiveComparison of the early and mid-term survival rate and complication rate of tricuspid valve plasty and tricuspid valve replacement in the treatment of moderate to severe tricuspid regurgitation after surgery, Evaluating the effect of tricuspid valve plasty and tricuspid valve replacement in the treatment of moderate to severe tricuspid regurgitation in order to provide a reference for this kind of operation.. MethodsA retrospective analysis of patients of tricuspid regurgitation with left cardiac valve disease or congenital heart disease in our hospital from January, 2003 to June,2008,Some patients with right heart failure symptoms and 228 patients were given treatment of tricuspid valve operation,among them 127 patients who accepted tricuspid valve plasty.101 patients who accepted tricuspid valve replacement. We collected the perioperative data, and followed-up 65 months, evaluating the outcomes of two surgical methods for treating tricuspid regurgitation ResultsTricuspid annuloplasty group,51 male,76 female,the average age of(57.97 + 9.24) years old,(tricuspid valve replacement group,52 male,49 female),the average age of(57.87±9.35) years old.Tricuspid valve repair group before surgery has 68 patients with moderate tricuspid valve regurgitation,49 patients with severe regurgitation, tricuspid valve replacement group has 41 patients with moderate tricuspid valve regurgitation,60 patients with severe regurgitation.The heart function classification of tricuspid valve plasty group were 22 cases(17.3%)of grade II,79 cases of grade III(62.2%),26 cases of grade IV(20.5%),and the classification of tricuspid valve replacement group were 11 cases(10.9%)of grade II,56 cases of grade III(55.4%), 34 cases of grade IV(33.7%).The rate of abnormal liver function of repair group(4.4%) before surgery was lower than replacement group were three(10.9%)(P=0.023), average Pulmonary arterial systolic pressure of repair group was(53.48 + 14.32)mmHg,lower than replacement group(57.62 + 14.65) mmHg(P=0.033), the other data of two group was no statistically significant difference( P>0.05). The replacement group’s average aortic cross-clamping time, cardiopulmonary bypass time, ventilation time and the staying time of ICU, the usage of inotropic drug were significantly higher than the repair group(P<0.01). Early term after surgery, two groups of patients’ the diameter of the heart, ejection fraction of left ventricle and pulmonary artery systolic pressure had no significant difference(P > 0.05), the complication rate of repair group(15.75%,20 patients)was lower than the replacement group(27.27%,27 patients)(P=0.042);the mortality rate of repair group(6.3%,8 patients)was lower than the replacement group(16.83%,17 patients)(P=0.011).. Long-term follow-up found that moderate to severe tricuspid regurgitation recurrence rate of repair group(28.7%) was higher than replacement group(8.75%)(P=0.011). Mid-term after surgery,heart function classification of repair group were 18 cases of grade I,88 cases of grade II, 9 cases of grade III,and the classification of replacement group were 11 cases of grade I,59 cases of grade II, 10 cases of grade III,but there was no statistically significant difference(P=0.713,0.659,0.279)The survival rate of patients in repair group was much higher than replacement group on 3 months,1,3,5 years after surgery. But the difference was not statistically significant(P=0.0231,0.089,0.133,0.078) ConclusionsIn the treatment of moderate to severe tricuspid regurgitation which leads to right heart failure, the early treatment effect of tricuspid valve plasty is much better than the tricuspid valve replacement. The mid-term after surgery, we found that moderate to severe tricuspid regurgitation recurrence rate after tricuspid valve repair surgery is higher than the rate after replacement surgery. |
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