Edwards MC3环是一类具 有三维空间构型的新型三尖瓣成形环【l引,设计的目的 是利用该环马鞍形的构型,以利于和三尖瓣环更好地 结合与固定,改善长期效果。该环在初步的使用中,显 示厂良好的效果015A6j。 在本组施行的三尖瓣成形中,我们使用了Carpen— tier—Edwards Classic、Sovering成形环和Edwards MC3 成形环,它们分别代表了传统的硬质成形环、弹性环和 新一代的具有立体构璎的硬质成形环。根据目前的中 期随访结果还不足以判断各成形环的优劣,需要更长 期的观察数据。 我们认为,各种三尖瓣成形环虽然各有特点,但 在植入过程中都需要准确地测量三尖瓣环的大小以 选择适宜尺寸的成形环。并且,该手术技术简单、可 重复性好,整个成形过程易于标准化,手术质量能得 到保证。同时,成形环内部材质的非延展性及固定 瓣环的缝线受力均匀都能有效防止三尖瓣环发生远 期的扩张并能确保整个成形手术的远期效果,因此 是值得推荐的手术方法。但是,由于三尖瓣反流形 成机制的复杂性,如右心室扩大导致的乳头肌移位 被认为也是造成三尖瓣反流的重要因素,因此要确 保该二尖瓣修复的长期、稳定的疗效还需要进一步 的临床研究J。 4参考文献 BmunwaldNS,Ross J,Morrow AG.Conservative mmnagement cuspidregurgitation patientsundergoing mitral valve replacement. Circulation,1967,35:163—169. [2】Matsnyama K,Matsumeto M.Sugita T,et a1.Predictors residualtri cuspid regurgitation after mitral valve surgery.Ann Tliorac su唱, 2003,75:1826一I 828. [3]Bemal JM,Morales D,Bevuelta C。et a1.Reopemtious after tricuspid valve mpair.J Thorac Cardiovasc Surg,2005,130:498-503. [4]Bonow RO,Carabello B,de Leon AC.et a1.ACC/AHA guidelines valvularheart disease.Executive Sununary.A report AmericanCoUege Cardiology/AmericanHeart Association Task Force PgacticeGuiddines(Committee 55Management PatientsWith Valvular Heart Dim).J Heart Valve Dis,1998,7:672-707. [5]Carrier M,Pellerin M,Guertin MC,et aL Twenty five years’clinical ecxperience tricuspidinsufficiency.J Heart Valve Dis, 2004。13(6):952-956. [6】Ghanta RK,Chen R,Narayanasamy N,et a1.Suture bicuspidization tricuspidvalve Yel|us ring annuloplasty functionaltri- cuspid regurgitation:midterm rtLt[ts 237consecutive patients.J Thorac Cardiovasc Sl】增,2007,133(1):1 17-126. [7]McCarthy PM,Bhudia SK,Raj瞄wmn J,et a1.Tricuspid valve repair: durability riskfactors failure.JThorac Cardiovasc sufg.2004; 127:674-685. [8]Tang GH,David TE,Singh SK,et a1.Tricuspid valve Mp丑ir annuloplastyring results impmvedlong-term outcomes.Circulation, 2006,114(1 Suppl):1577-581. [9]Matsuyama K,Matsumoto M.Sugita T,et al,De Vega annuloplesty Carpentier-Edwantsring annuloplasty secondarytricuspid regurgi- ration.J Heart Valve Dis,2001。10(4):520 [10]HolperK,Haehnel JC,Augustin N,et a1.Surgery tricuspidinsuf- ficiency:long-term follow-up after De Vega annuloplasty.Thorac Cardiovasc Surg.1993,41(I):1-8. [11]Dl铆us GD,Corbi PJ,Chan 104,et a1.Secondary tricuspid regur画ta- tion dilatation:whichshould surgicalrer血? Ann Thorac Surg.2005 Jan;79(1):127-132. [12]Sngimoto T,Okada M。Ozaki N,et 81.Long-term evaluation tge.at-went functionaltricuspid regurgitatiou regursimtvolume: characteristic differences based Oll priIIlary cardiac lesion.J Thortw Cardiovasc Surg,1999,117(3):463-471. [13] Minato N,ltoh T.Direct imaging tricuspidvalve annular mo- tions fiberopticeardioscopy dogswitll tricuspid regurgitation. II.Does flexible ring annuloplasty preserve annularmotions?J Thorac Cardiovasc Surg,1992,104(6):1554-560. [14]Fukuda S,Gillinov AM。McCmthy PM,et a1.Echocardiographic fol- low—up tricuspidannuloplasty anowthree—dimensional ring functionaltricuspid regurgitation.J Am See gcheeardio- gr,2007,20(1 1):1236—1242. [15]Filsonii F,Salzberg SP,Abaseal V,et a1.Sufgieal management functionaltricuspid regurgitation anowremodeling annuloplasty ring.Mt Sinai JMed,2006,73(6):874-879. [16]Midorikawa H,Satou K。lshikawa K,et a1.A prosthetic ring annulo- plmy edge—to-edgerepair atreatmentof卵mtricuspid gurgitation.KyobuGeka。2008,61(4):331-334. [17】Raja SG,DI哪us GD。Surgery functionaltricuspid regurgitation: current techniques,outcu嬲and emerging concepts. Expert Rev Cardiovasc Ther,2009,7(1):73-84. (收稿日期:2008-04 14) (编辑:壬宝茹) 万方数据 万方数据