Objective: To summarize the outcome of tricuspid valve replacement.
Methods: A total of 28 patients (15 males and 13 females) underwent tricuspid valve replacement from March 2000 to February 2015 in the First Affiliated Hospital of Zhengzhou University were recruited. Among them, 16 patients were Ebstein's anomaly, 7 had rheumatic valve heart disease, 3 and 2 suffered from infective endocarditis and degenerative tricuspid lesions, respectively.
Results: One patient died of multiple organ failure. Four patients were implanted permanent cardiac pacemaker because of third degree atrioventricular block occurring in the 5th day (2 patients) and in the 9th day (2 patients) after the operation, respectively. Twenty-seven patients were followed up from 1 month to 15 years. The prosthetic valves and permanent pacemakers worked well.
Conclusion: Third degree of atrioventricular block, mostly appearing in early postoperative period, is the most common and severe complication of tricuspid valve replacement. The key point for prevention of damage is to accurately identify the anatomical relationship among the tricuspid valve, atrioventricular node, and conduction bundle.
目的：总结三尖瓣置换术的临床治疗经验。方法：回顾性分析2000年3月至2015年2月在郑州大学第一附属医院心外科行三尖瓣置换术的28例患者的临床资料，其中男15例，女13例，年龄5~63(39.84±16.27)岁。病因主要有三尖瓣下移畸形(Ebstein畸形)16例，风湿性心脏瓣膜病7例，感染性心内膜炎3例，退行性三尖瓣病变2例。结果：1例术后因多器官功能衰竭死亡；4例术后出现三度房室传导阻滞，其中2例出现于术后第5天， 2例出现于术后第9天，均置入永久起搏器；27例患者顺利出院。术后随访1个月~15年，27例患者心脏超声示人工瓣膜功能良好，4例置入永久起搏器患者的起搏器功能良好。结论：三度房室传导阻滞是三尖瓣置换术最常见且严重的并发症，大多发生于术后早期，关键在于预防，术中要准确辨认三尖瓣与房室结、传导束的解剖关系，尽量避免损伤。.