外科修复功能性三尖瓣反流:旧课题的新认识  

Surgical Repair of Functional Tricuspid Regurgitation:An Old Issue Revisited

作　　者：胡佳[1] 康宁[1] 万松[1] 

机构地区：[1]香港中文大学医学院威尔斯亲王医院心胸外科

出　　处：《中国胸心血管外科临床杂志》2010年第6期494-498,共5页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

摘　　要：目前外科修复功能性三尖瓣反流(functional tricuspid regurgitation,FTR)多在左心瓣膜手术同期施行,即使术中处理了左心瓣膜和三尖瓣病变,术后残留或复发的不同程度三尖瓣反流均会持续进展并危害患者的远期生存。现今各种三尖瓣修复技术主要是针对FTR中瓣叶交界、瓣环和瓣叶水平的病变,但术后仍存在着一定的中远期失效率,而复发患者再手术难度大且病死率较高。随着对三尖瓣解剖复合体认识的加深及瓣膜成形理论的发展,临床上对FTR首次外科修复的指征和方法有了更成熟的共识。因此,为了能更好地把握三尖瓣成形的手术指征与方法,我们根据近年文献,着重探讨各种三尖瓣成形手术指征的进展,并比较多种常用的三尖瓣成形方法及其远期效果。Surgical repair of functional tricuspid regurgitation（FTR） is often carried out concomitantly with other left-sided heart valve procedures.Though diseases of both left heart valve and tricuspid were treated during the surgery,postoperative residual or recurrent tricuspid regurgitation has been clearly associated with progressive heart failure and worsened long-term survival.To date,surgical interventions mainly address FTR at three anatomic levels： commissure,annulus and leaflets.However,a certain mid and long-term failure rate after operation still exists.High surgical mortality rates have been reported in patients with recurrent tricuspid regurgitation requiring complex reoperations.With a better understanding of tricuspid anatomical complex and valvuloplasty,significant improvements have been made in FTR surgical indications and techniques.This review article will focus on the development of surgical indications in tricuspid valve repair,while the repair techniques and their impact on long-term clinical outcome will also be compared.

关 键 词：功能性三尖瓣反流 瓣膜成形术 手术指征 临床疗效 

分 类 号：R654.2[医药卫生—外科学]