| Objective : The clinical efficacy of different tricuspid valves with tricuspid regurgitation of tricuspid valve was compared,and the optimal curative effect of these patients after surgery was provided.Methods:Retrospective selection of 2015.06 to 2016.12 in the 1st affiliated hospital of bengbu medical college chest cardiac surgery functional tricuspid regurgitation with other heart diseases(including simple valvular disease,congenital heart disease [,ventricular septal defect,atrial septal defects] or valvular disease + coronary heart disease(CHD)to coronary artery bypass grafting(coronary artery bypass grafting,CABG))of 94 cases patients with one line of tricuspid valve suture keratoplasty(Kay 'S operation or De Vega)of 50 cases of patients with(suture group,group A),artificial ring line of tricuspid valve plasty(Carpentier ring)of 44 cases of patients with(forming ring group,group B).Statistics of gender,age,preoperative complications,surgical procedure,intraoperative and postoperative complications,preoperative and postoperative cardiothoracic ratio,preoperative and postoperative cardiac function classification,preoperative and postoperative pulmonary hypertension,preoperative and postoperative cardiac ejection fraction and heart ultrasonic indicators,such as by telephone,outpatient follow-up visit after surgery.Results:42 cases of the patients 94 cases,men,women,52 cases tricuspid suture forming group of preoperative basic situation: a total of 50 cases,24 cases of male,female 26 patients,average age(48.95 ± 8.45 mm),light,medium and severe tricuspid regurgitation in 12 cases,26 cases respectively and 12 cases;There were 3 cases of cardiac function I,22 cases in grade II,16 in class III and 9 in class IV.Thoracic thoracic ratio >0.6 was 18 cases;There were 16 cases,24 cases and 10 cases of pulmonary hypertension.Left heart ejection fraction,Left ventricular ejection fraction,LVEF)< 50% in 17 cases.Before operation,there were 44 cases,18 males and 26 females,with an average age(48.68±8.27),with 11 cases,23 cases and 10 cases,respectively.Cardiac function I level 2,grade II 13,class III 18,IV grade 11;The thoracic thoracic ratio >0.6 was 21 cases;There were 11 cases,25 cases and 8 cases of pulmonary hypertension in the forming ring group.LVEF<50% has 19 cases.Tricuspid valve forming ring group average aorta blocking time(79.30±20.64)min,extracorporeal circulation time(117.38±37.56 min)higher than that of tricuspid suture group(59.53±18.59)min and(93.56±28.75)min,and there are significant differences(P < 0.05),bleeding amount of tricuspid valve forming ring group(397.54 ±243.46)bleeding amount of ml and tricuspid suture group(389.62±238.57)ml,no obvious difference was found between two groups(P > 0.05).Tricuspid valve forming ring group average postoperative respiratory machine auxiliary time(22.32±18.73)h,ICU guardianship time(3.57±1.27)d,pericardium,mediastinum,or chest drainage tube(305.36±217.84)drain the ml and tricuspid suture group(20.73±17.52)of h,(3.49±1.32)d,ml(312.51±208.37)there was no significant difference(P > 0.05).Suture group average level(2.6±0.8),preoperative cardiac function after 6 months(1.5±0.4)and postoperative 1 year(1.2±0.2),respectively,and forming ring group(2.8 ± 0.7)for preoperative and postoperative 6 months(1.4 ± 0.3),postoperative 1 year(1.1±0.1)difference was statistically significant(p < 0.05);Suture group and forming ring were discharged from hospital 1 week before,after 6 months,1 year after operation respectively and the difference was statistically significant(p < 0.05),postoperative 1 year and 1 week before discharge difference was statistically significant(p < 0.05).Suture group average preoperative pulmonary artery systolic pressure(50.48±14.32)mm Hg,six months after operation(30.52±12.72)mm Hg,postoperative 1 year(24.36±12.63 mm Hg,respectively,and forming ring group(58.23 ±15.26)for preoperative mm Hg,six months after operation(29.16 ± 11.86)mm Hg,postoperative 1 year(22.73 ± 12.17)mm Hg difference was statistically significant(p < 0.05);Suture group and forming ring were discharged from hospital 1 week before and after 6 months and after 1 year and the difference was statistically significant(p < 0.05),postoperative 1 year and 1 week before discharge difference was statistically significant(p < 0.05).RAD suture group after 6 months(47.67 ±47.67)mm,RVD(16.63 ±3.42)mm,after 1 year RAD(42.56 ± 42.56)mm,RVD(15.13 ± 3.37)mm respectively compared with preoperative RAD(53.49±53.49)mm,RVD(21.43±4.62)mm difference was statistically significant(p < 0.05),forming ring group 6 months postoperative RAD(46.37±46.37)mm,RVD(17.68±3.67)mm,after 1 year RAD(40.75±9.58)mm,RVD(15.47±3.13)mm respectively compared with preoperative RAD(56.23 ± 11.43)mm,RVD(22.14 ± 4.39)mm difference was statistically significant(p < 0.05),forming ring after 6 months and suture group difference was statistically significant(p < 0.05).There were statistically significant differences in the recurrence and suture group of tricuspid regurgitation(p<0.05)after 1 year after operation.Conclusion:1.The tricuspid valve plasty were increased significantly in patients with postoperative clinical curative effect,mainly reflects in: patients with EF < 50% decrease,cardiothoracic ratio > 0.6 has improved significantly,the average postoperative pulmonary artery systolic blood pressure significantly decreased,the right atrium and right ventricle reduce obviously.2.The curative effect of artificial valve annuloplasty is better than that of suture,which is mainly manifested in: the right atrium and right ventricle are smaller than the suture group,and the reverse flow rate is significantly lower than that in the suture group. |
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