Evaluation Of Therapeutic Efficacy And Its Determinants Of Tricuspid Valvuloplasty By Echocardiography

Objective:To evaluate therapeutic efficacy and its determinants of tricuspid valvuloplasty(TVP)by echocardiography.Methods:The data of 88 cases of TVP performed in the Department of Cardiac Surgery of Fujian Union Hospital from January 2010 to December 2012,whose follow-up period exceeded 4 years,were chosen for retrospective analysis.Take account of the previous studies and the characteristics of the patients to select echocardiographic and clinical variables which may relate to the therapeutic efficacy of TVP,comprising age,sex,New York Heart Association classification(NYHA),body surface area(BSA),smoking,hypertension,diabetes,atrial fibrillation(AF),distension of jugular vein,hepatomegaly,edema of lower extremity,preoperative tricuspid regurgitation(TR),postoperative time,preoperative and postoperative right ventricular diameter(RV),left ventricular end-diastolic diameter(LVEDD),left ventricular ejection fraction(LVEF),pulmonary artery systolic pressure(PASP),surgical method,rheumatic disease,concomitant mital valvuloplasty,aortic valve replacement,mitral valve replacement and double valve replacement.Multivariate logistic regression analysis was used to help to identify determinants of postoperative TR after TVP.Compare the effect of improvement of postoperative TR of the two different surgical method.Results:Multivariate logistic regression analysis showed that the variables falling into the model are preoperative TR(P=0.001,OR=3.974),postoperative time(P=0.005,OR=2.588)and surgical method(P=0.047,OR=4.859).The regression coefficients of these three factors are 1.380,0.951 and 1.581.In invalids who have mild preoperative TR,there is no difference in postoperative TR between two groups(P=0.658).In patients with severe preoperative TR,there is no difference in postoperative TR between two groups(P=0.745).In patients with moderate preope rative TR,though there is no difference in the severity of preoperative TR(P=0.307),the severity of postoperative TR in ring group is lower than suture group(P=0.017).Conclusions:The determinants of postoperative TR are preoperative TR,postoperative time and surgical method.In patients with moderate preoperative TR,we recommend using rings,because the severity of postoperative TR in ring group is lower than suture group.