| OBJECTIVE:To compare the results of Edwards MC3 and De Vega on patients with heart valve disease and secondary tricuspid regurgitation receiving tricuspid valvuloplasty(TVP)during mitral valve replacement(MVR)and/or aortic valve replacement(AVR),and to analyze factors contributing to post-operation recurrence of tricuspid regurgitation.METHODS : 60 patients with heart valve diseases and secondary tricuspid regurgitation who received TVP during MVR and/or AVR between January 2015 and March 2016 at Sichuan Mianyang 404 Hospital.Under the principle of random grouping,the cases were divided into two groups using “Envelope Method”,one is Group MC3,the other Group De Vega,with 30 cases in each group.We collected patients' general information,NYHA classifications,ultrasonic cardiograms and operation-related indexes,did follow-ups on cardiac functions and ultrasonic cardiograms one week,three months,six months and a year after operations.Left ventricular cardiac function?pulmonary artery systolic pressure(s PAP)?left atrial diameter,left ventricular diameter,right atrial diameter,right ventricular diameter and severity of tricuspid regurgitation prior to and after operations were recorded,to compare the results of Edwards MC3 and De Vega on patients with heart valve diseases and secondary tricuspid regurgitation receiving TVP during mitral valve replacement and/or AVR.RESULTS:The general information(P>0.05),atrial and ventricular diameters examined by transthoracic echocardiography(P>0.05)is not statistically significant.Of Group MC3 and Group De Vega,the LVEF(%)s prior to operations are 51.51±6.38 and 50.13±6.06,tricuspid annulus diameters are 45.57±8.85 and 45.40±8.27,tricuspid regurgitation are2.26±1.07,s PAP(mm Hg)are 49.37±13.09 and 47.23±13.37,these results(P>0.05)are of no statistic significance.Aside from TVP,the operations(P>0.05)show no significant differences.In durations of operation,extracorpeal circulation,ascending aorta blockage,ICU stays and total hospital stays,results of the two groups(P>0.05)are not statistically significant.NYHA classifications between and within the two groups prior to and after the operations(P>0.05)are not statistically significant.The NYAH classification three,six and twelve months after the operations,have all improved(P>0.05),which is of no statistic significance.One week after operations,cardiac functions were worse than before the operations(P<0.05,statistically significant),this is due to not being fully recovered.But for the same period after operations,the cardiac functions show no significant differences(P>0.05).In post-operation and follow-up period,tricuspid regurgitation compared to prior-surgery period and tricuspid regurgitation classification have improved in both groups(P<0.05).One week,three months,six months and one year after operations,there are no significant differences between two groups in tricuspid regurgitation(P>0.05).The Diameters of the tricuspid annulus were significantly decreased(P<0.05)compared with preoperation at 3 weeks,6 months and 12 months after the MC3 forming ring group and De Vega suture group and there were none reexpansion.CONCLUSION:TVP is vastly used in treating patients with heart valve disease and secondary tricuspid regurgitation.For secondary tricuspid regurgitation,tricuspid regurgitation decreased and NYAH classification improved distinctly in early-to-middle stage with De Vega.While using Edwards MC3,tricuspid regurgitation can be controlled and cardiac functions improved in early.The short-term tricuspid annulus diameters were significantly reduced to normal size,fixed firmly,and showed no sign of reexpansion using either Edwards MC3 forming ring or De Vega angioplasty.The effects of both De Vega and Edwards MC3 for secondary tricuspid regurgitation in early stage are undeniable and there is no significant differences between these two methods.Further study in long-term effects is still required,which can also provide clinical evidences for secondary tricuspid regurgitation treatments. |
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