Risk factors of residual reflux in patients with functional three tricuspid insufficiency

doi:10.3969/j.issn.1672-5301.2018.02.019

Abstract：Objective To investigate the clinical effects of four gasket modified Devega procedure and BalMedic valvuloplasty in patients with functional tricuspid insufficiency,and the risk factors for the residual reflux of the tricuspid after operation.Methods By retrospective study,112 cases undergone with tricuspid valvuloplasty in Jiangmen Central Hospital affiliated to Zhongshan University from January 2006 to July 2011 were enrolled,in which there were 58 cases accepted modified Devega ring with four gasket constriction and 54 cases accepted with BalMedic soft forming ring.The degree of tricuspid regurgitation and the risk factors of postoperative residual tricuspid regurgitation were compared between the two groups after 4-5 years(mid-term).Results After 4-5 years follow-up,tricuspid regurgitation area were significantly reduced in two groups(in Devega group,severe tricuspid regurgitation decreased 33 cases,accounting for 56.9％ of the total cases;in BaiMedic group compared with preoperative reduced in 39 cases,accounting for 72.2％ of the total cases),compared with preoperative heart function were improved significantly (in Devega group,patients with heart function Ⅰ-Ⅱ compared with the preoperative increased in 18 cases,accounting for 31％ of the total cases;in BaiMedic group comparel with the preoperative increased in 20 cases,accounting for 37％ of the total cases).There were 12 cases with postoperative residual regurgitation,7 cases were in group Devega,5 cases in BalMedic group.Rheumatic disease,postoperative low LVEF postoperation,large right atrium,large postoperative tricuspid annulus diameter,postoperative pulmonary hypertension were the independent risk factors of residual regurgitation after tricuspid valvuloplasty (P＜0.05).The residual regurgitation in two groups of patients with clinical data of follow-up analysis.Conclusion Modified Devega operation and artificial valve ring with four gasket plasty is an effective method for the treatment of functional tricuspid regurgitation;rheumatic etiology and low postoperative left ventricular ejection fraction,postoperative pulmonary hypertension,postoperative large tricuspid annulus and postoperative large right atrium are risk factors for residual tricuspid regurgitation.