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三尖瓣硬质三维立体成形环成形术的疗效临床观察

论文作者:www.51lunwen.org论文属性:硕士毕业论文 thesis登出时间:2013-08-26编辑:yangcheng点击率:3011

论文字数:821论文编号:org201308251525457347语种:英语 English地区:中国价格:免费论文

关键词:FTR医疗论文医疗作业代写

摘要:本组采用三尖瓣硬质三维立体成形环(国产佰仁思三尖瓣硬环)行三尖瓣成形术。旨在观察三尖瓣成形后的中期疗效,比较人工瓣环组和对照组(DeVega或Kay成形术)的中期治疗效果。

Functional tricuspid regurgitation (functional tricuspid regurgitation, FTR), also known as secondary tricuspid regurgitation is common in left heart disease cause pulmonary hypertension and right ventricular enlargement.

多种病因可引起FTR,其共同特点是引起肺动脉高压和右心室扩大。如风湿性瓣膜疾病、先天性心脏病、瓣膜退行性病变、感染性心内膜炎、缺血性心脏病、扩张性心肌病、原发性肺动脉高压、肺心病等。在我国,风湿性心脏病是首要病因。

A variety of causes can cause FTR, their common characteristic is caused by pulmonary hypertension and right ventricular enlargement. Such as rheumatic heart disease, congenital heart disease, valvular degenerative disease, infective endocarditis, ischemic heart disease, dilated cardiomyopathy, primary pulmonary hypertension, pulmonary heart disease and so on. In China, rheumatic heart disease is the primary cause.

FTR多为继发于风湿性二尖瓣病变的晚期,由于严重的肺动脉高压引起右心室扩大,使三尖瓣环扩大导致严重关闭不全。大多数研究认为,三尖瓣瓣环扩大是FTR的最终机制[1,2,3],瓣叶被牵拉及三尖瓣环扩大的程度决定了FTR的程度。

FTR mostly secondary to rheumatic mitral valve disease late, due to severe pulmonary hypertension caused by right ventricular enlargement, expanding the lead to severe tricuspid regurgitation. Most studies suggest that enlargement of the tricuspid valve ring FTR ultimate mechanism [1,2,3], and tricuspid valve leaflets are pulled ring expansion level determines the extent of FTR.


FTR surgical indications currently no uniform conclusion. Has been widely recognized that the preoperative significant TR (moderate and above), the need to deal with the same period of primary disease tricuspid regurgitation be treated. Should mild to moderate TR concomitant surgery is still controversial. Secondary to left heart valvular disease with tricuspid regurgitation after treatment will not be reversed the disease better, or even gradually increased. Therefore, even if no symptoms of the patient, it should be in the left heart valve surgery at the same time actively tricuspid regurgitation [4,5]. Tricuspid regurgitation is a major cause of the expansion valve annulus, valve itself has no obvious lesions, in recent years, many scholars advocate the line left heart valve replacement surgery at the same time tricuspid valve annuloplasty to improve surgical efficacy and improve right ventricular function .


Tricuspid valvuloplasty is currently divided into a shaped ring and ring without forming two major surgical procedures. Use of surgical forming rings into: Carpentier artificial rigid annuloplasty, Duran Flexible annuloplasty, Cosgrove-Edwards artificial soft annuloplasty, Edwards MC3 annuloplasty; without forming rings of surgical divided into: Kay angioplasty, DeVega angioplasty and modified DeVega angioplasty. Kay forming method, while saving time and easy to operate, but only remove the expansion valve ring 1/2, and is easy to make tricuspid stenosis, surgery is less effective. DeVega plasty method is simple, and low cost of surgery, and postoperative anticoagulant treatment without short, infective endocarditis complicated by chance is low, is still widely used, and a variety of modified DeVega surgery have made good effect [6,7,8,9], but the past 20 years, there were reports that the classic DeVega banding surgery can not completely annulus around, but also because other factors affect the suture avulsion term efficacy [10,11,12], especially for severe tricuspid regurgitation and / or in patients with pulmonary hypertension. Instead, the application forming rings angioplasty to restore the normal form of the tric论文英语论文网提供整理,提供论文代写英语论文代写代写论文代写英语论文代写留学生论文代写英文论文留学生论文代写相关核心关键词搜索。

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