| Objective : To evaluate the early or middle effect and effect comparison of Devega and artificial ring annuloplasty to the patients of moderate and severe secondary tricuspid insufficiency.Methods:Between January 2012 to May 2017,78 patients of moderate and severe secondary tricuspid insufficiency underwent open heart surgery with tricuspid valve plasty in the Department of Cardiovascular Surgery of The general Hospital Of Ningxia Medical University,including valvular lesion of left heart system and atrial septal defect patients.They were divided into two groups by different tricuspid valvuloplasty(TVP),modified De Vega tricuspid annuloplasty group(n=45)and artificial ring tricuspid annuloplasty group(n=33),They were also divided into moderate secondary tricuspid insufficiency group(n=65)and severe secondary tricuspid insufficiency group(n=13).All patients were reviewed and followed-up in 1 week,6 months after operation,I collected right atrial ventricular diameter of echocardiography measurement results,the preoperative and postoperative right atrial ventricular diameter of two groups of patients were analyzed by SPSS20.0 T test and rank-sum test,surgical efficacy of two different operative methods were compared to analyse according to the statistical results.Results:Among all the patients,there were 18 males and 27 females in Devega group with an average age of(51.67±10.09)years,There were 9 males and 24 females in the artificial ring group,with an average age of(52.24 + 8.38)years,there were 9 males and 24 females in theartificial ring group with an average age of(52.24 + 8.38)years.Devega group of preoperative tricuspid regurgitation:moderate to severe =40:5,after operation the death was2 cases,no tricuspid regurgitation was 19 cases,a small amount of regurgitation was 3cases,mild regurgitation was 20 cases,moderate regurgitation was 2 cases;Artificial ring group of moderate to severe =25 : 8,after operation death was 2 cases,no tricuspid regurgitation was 15 cases,a small amount of regurgitation was 2 cases,mild regurgitation was 12 cases,moderate regurgitation was 1 cases;There was no statistically significant difference in preoperative data between Devega group and artificial ring group(P > 0.05),Right ventricular outflow tract diameter,right ventricular anteroposterior diameter,main pulmonary artery diameter,superior and inferior of right atrium diameter and right atrium transversal diameter were significantly decreased in two groups at 1 week after operation(P <0.05).In Devega group,there was no statistical significance in the six months and 1 week after operation(P > 0.05),but the main pulmonary artery diameter increased,right ventricular outflow tract diameter and uperior and inferior of right atrium diameter in artificial ring group were still decreased compared with the six months and 1 week after operation(P < 0.05).There was no significant difference between the two groups in the early and middle period after operation(P > 0.05),but the evaluation index of artificial ring group was larger than that of Devega group.The early period right heart diameter of severe secondary tricuspid insufficiency was significantly lower than that in the moderate patients(P < 0.05),except for right ventricular outflow tract diameter.Among all the patients,the ejection fraction of patients had most significant difference(P < 0.01),the postoperative EF decreased in moderate patients and severe patients,EF increased.Conclusion : TVP can help recovery of the moderate and severe secondary tricuspid insufficiency patients,right heart function in the early and mid-term after operation.the effect of artificial ring annuloplasty is better than that of Devega annuloplasty,in artificial ring group,The right atrium diameter of Postoperative half year increased more than 1 weeks after operation.In addition,the effect of the severe secondary tricuspid insufficiency patients is more obvious than the moderate patients. |
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