| ObjectiveTo estimate the influence of the TVP to the right ventricular function with evaluation of right ventricular function of patients of functional tricuspid insufficiency underwent tricuspid valve anuloplasty(TVP) by real-time three-dimensional echocardiography(RT-3DE) and strain rate imaging(SRI) preoperatively and postoperatively.Meanwhile to compare the outcome of the use of De Vega annuloplasty with artificial tricuspid rings in TVP.MethodsThe population of this study consisted of 9 healthy volunteers(4 men;mean±SD age,29.4±8.6years) and 33 patients(12 men;mean±SD age,54.5±13.0years) with functional tricuspid regurgitation(TR).Healthy volunteers had no history of cardiovascular disease and symptoms and had normal results on their echocardiographic examination.Two-dimensional and real-time three-dimensional echocardiography were performed in all the patients to get the statistics and images needed for both three-dimensional echocardiography and strain rate imaging before operation.And preoperative echocardiography documented mild tricuspid regurgitation in 9 patients,moderate regurgitation in 10 and severe regurgitation in 14, according to which the patients were divided into three groups of the mild-regurgitation group,the moderate-regurgitation group and the severe-regurgitation group.All the patients underwent operation on the left-sided diseases.Meanwhile,14 patients underwent De Vega annuloplasty and artificial tricuspid rings were used in 7 patients.All the patients recovered postoperatively and were followed up from 1 to 3 months.Within the follow-up,all the patients were asked to have the performance of two-dimensional echocardiography to get the same statistics and images as those preoperatively at least once.All the images and statistics were put into computer for the further evaluation of the right ventricular function with the help of 4D-RV function and Q-lab software for real-time three-dimensional echocardiography and strain rate imaging.Results:1.All the patients recovered postoperatively without any severe complications. There was significant improvement in mean NYHA classification and tricuspid regurgitation postoperatively.2.There was a great increase in RVEDV and RVESV in the patients of moderate and severe-regurgitation group in compare with those of mild-regurgitation group and healthy volunteers.By the follow-up point postoperatively,the decrease of RVEDV and RVESV was detected in the group of both moderate and severe-regurgitation group.3.A gradually decrease in the strain of the free wall of the right ventricle,especially in the basal and middle segments,could be shown in the group of moderate and severe-regurgitation group.Within 3 months postoperatively,we could see an obvious improvement in the strain of the basal segment of the free wall of the right ventricle in the group of moderate and severe-regurgitation group.4.There was no difference in the short-term recovery of the patients underwent TVP with no matter De Vega annuloplasty or artificial tricuspid rings.The right ventricular function was improved in the patients who underwent TVP within the follow-up.Conclusions:1.The right ventricular function were impaired in the patients suffered from FTR, especially in those with moderate or severe TR.Proper treatment of FTR can obviously improve the right function postoperatively and influence the long-term recovery of the patient. 2.Real-time three-dimensional echocardiography(RT-3DE) and Strain and strain rate imaging(SRI) can estimate the function of the right ventricle.RT-3DE and SRI would have the potential to be the normally used measurement of the assessment of the function of the right ventricle.3.There was no short-term difference in the recovery with the treatment of De Vega annuloplasty and artificial tricuspid rings.4.With the development of the relative techniques and technologies,RT-3DE and SRI could be widely used in the assessment for the right ventricular function generally in the near future.
|
PDF Full Text Request