PDF(Pubmed)
Abstract：
UNASSIGNED: Leaflet augmentation is often required to correct an inadequate leaflet size due to leaflet thickening, contracture and junctional fusion in patients with tricuspid valve regurgitation (TR) after left-side valve surgery (LSVS). However, the ideal material for leaflet augmentation remains controversial. This article aims to compare the medium- and long-term results of tricuspid valve repair with bovine pericardium (BP) and expanded Polytetrafluoroethylene (ePTFE) patches for the augmentation of tricuspid leaflets and to compare the durability of the two materials.
UNASSIGNED: From January 2015 to April 2023, a total of 69 patients with severe isolated TR underwent tricuspid valvuloplasty (TVP) by leaflets augmentation with patches in our institute. According to the different types of patches, they were divided into the BP group (n = 44) and the ePTFE group (n = 25).
UNASSIGNED: There were 3 perioperative deaths (4.3%), one case was due to low cardiac output syndrome in the BP group, and 2 cases were due to acute respiratory dysfunction syndrome and low cardiac output syndrome in the ePTFE group, respectively. Before discharge, the area of the TR jet on echocardiography decreased from 23.5 ± 9.1 to 4.2 ± 3.4 cm 2 . One case in each group was found to have increased blood flow velocity at the tricuspid orifice. After discharge, one patient in each group underwent repeat TVP, in the BP group because of shortened chordae and in the ePTFE group because of calcification of the patch. During the entire follow-up period, there were 7 cases of severe TR (10.1%), 5 in the BP group and 2 in the ePTFE group, a total of 5 cases of tricuspid stenosis (7.2%), 4 in the BP group and 1 in the ePTFE group, and a total of 6 deaths (8.7%), 5 in the BP group and 1 in the ePTFE group. Transthoracic ultrasound in a patient with tricuspid stenosis suggests stiff leaflet movement and poor motion.
UNASSIGNED: Leaflet patch enlargement can be safely used in tricuspid valve repair, but BP patches carry a risk of reduced flexibility and stiffness of movement, and ePTFE patches carries a risk of calcification.
UNASSIGNED: From January 2015 to April 2023, a total of 69 patients with severe isolated TR underwent tricuspid valvuloplasty (TVP) by leaflets augmentation with patches in our institute. According to the different types of patches, they were divided into the BP group (n = 44) and the ePTFE group (n = 25).
UNASSIGNED: There were 3 perioperative deaths (4.3%), one case was due to low cardiac output syndrome in the BP group, and 2 cases were due to acute respiratory dysfunction syndrome and low cardiac output syndrome in the ePTFE group, respectively. Before discharge, the area of the TR jet on echocardiography decreased from 23.5 ± 9.1 to 4.2 ± 3.4 cm 2 . One case in each group was found to have increased blood flow velocity at the tricuspid orifice. After discharge, one patient in each group underwent repeat TVP, in the BP group because of shortened chordae and in the ePTFE group because of calcification of the patch. During the entire follow-up period, there were 7 cases of severe TR (10.1%), 5 in the BP group and 2 in the ePTFE group, a total of 5 cases of tricuspid stenosis (7.2%), 4 in the BP group and 1 in the ePTFE group, and a total of 6 deaths (8.7%), 5 in the BP group and 1 in the ePTFE group. Transthoracic ultrasound in a patient with tricuspid stenosis suggests stiff leaflet movement and poor motion.
UNASSIGNED: Leaflet patch enlargement can be safely used in tricuspid valve repair, but BP patches carry a risk of reduced flexibility and stiffness of movement, and ePTFE patches carries a risk of calcification.
摘要：
■通常需要增加小叶以纠正由于小叶增厚而导致的小叶尺寸不足，左侧瓣膜手术（LSVS）后三尖瓣返流（TR）患者的挛缩和交界融合。然而,增页的理想材料仍有争议。本文旨在比较牛心包（BP）和膨体聚四氟乙烯（ePTFE）补片对三尖瓣瓣扩张的中期和长期效果，并比较两种材料的耐久性。
■从2015年1月至2023年4月，共有69例严重孤立性TR患者在我们研究所接受了三尖瓣成形术（TVP）。根据补丁的不同类型，将其分为BP组（n=44）和ePTFE组（n=25）。
■围手术期死亡3例（4.3%），其中一例是由于BP组的低心输出量综合征,ePTFE组有2例因急性呼吸功能障碍综合征和低心排血量综合征,分别。出院前,超声心动图上TR射流的面积从23.5±9.1减少到4.2±3.4cm2。发现每组中的一例三尖瓣口血流速度增加。放电后,每组有一名患者接受重复TVP,在BP组中，由于腱索缩短，在ePTFE组中，由于斑块钙化。在整个随访期间,有7例严重TR（10.1％），BP组5和ePTFE组2，三尖瓣狭窄5例(7.2%),BP组4个，ePTFE组1个，及共有6人死亡(8.7%),BP组5和ePTFE组1。三尖瓣狭窄患者的经胸超声提示小叶运动僵硬且运动不良。
■小叶补片扩大可安全地用于三尖瓣修复，但是BP贴片会降低运动的灵活性和刚度，和ePTFE贴片有钙化的风险。
■从2015年1月至2023年4月，共有69例严重孤立性TR患者在我们研究所接受了三尖瓣成形术（TVP）。根据补丁的不同类型，将其分为BP组（n=44）和ePTFE组（n=25）。
■围手术期死亡3例（4.3%），其中一例是由于BP组的低心输出量综合征,ePTFE组有2例因急性呼吸功能障碍综合征和低心排血量综合征,分别。出院前,超声心动图上TR射流的面积从23.5±9.1减少到4.2±3.4cm2。发现每组中的一例三尖瓣口血流速度增加。放电后,每组有一名患者接受重复TVP,在BP组中，由于腱索缩短，在ePTFE组中，由于斑块钙化。在整个随访期间,有7例严重TR（10.1％），BP组5和ePTFE组2，三尖瓣狭窄5例(7.2%),BP组4个，ePTFE组1个，及共有6人死亡(8.7%),BP组5和ePTFE组1。三尖瓣狭窄患者的经胸超声提示小叶运动僵硬且运动不良。
■小叶补片扩大可安全地用于三尖瓣修复，但是BP贴片会降低运动的灵活性和刚度，和ePTFE贴片有钙化的风险。
