Echocardiography diagnosis and surgical outcome of rheumatic tricuspid valve disease / 中华超声影像学杂志

ABSTRACT

Objective To review the patients with rheumatic tricuspid valve disease ( RTVD) who were confirmed in cardiac operation and underwent tricuspid valve repair ,and summarize two and three-dimensional echocardiography ( 2D-STE ,3D-STE) characteristics of RTVD ,and evaluate the surgical procedures and outcomes of RTVD . Methods Between December 2009 and December 2017 ,359 patients with rheumatic heart disease ( RHD) underwent left-sided valvular replacement were enrolled . During the operation , 56 patients with RTVD were confirmed . All patients underwent 2D-STE and 3D-STE preoperatively . The preoperative echo characteristics of RTVD and the procedure of tricuspid valvular repair were reviewed . The morphology and function of tricuspid valve were followed after operation . Results Fifteen patients with RTVD were diagnosed by transthoracic echocardiography( TTE) preoperatively .Eight patients were presented tricuspid stenosis . Tricuspid annulus diameter [ ( 40 .3 ± 5 .6 ) mm ] , tethering distance[(5.9±2.2)mm] ,andpulmonaryarterysystolicpressure[(46.3±15.9)mmHg(1mmHg=0.133 kPa) ] were measured by echocardiography ,preoperatively . Moderate and severe tricuspid regurgitation were presented in 32 patients( 57 .1％ ) . All patients underwent tricuspid valvular repair . During the mean follow-up (78 .9 months) ,tricuspid annulus diameter was reduced and tricuspid regurgitation was relieved . Recurrent tricuspid regurgitation occurred in 8 patients(14 .3％ ) . Conclusions Preoperatively 2D-STE and 3D-STE need to evaluate tricuspid valve very carefully . Compared with functional tricuspid regurgitation , RTVD has some characteristics ,including more serious tricuspid reflux grade ,higher tethering distance ,the mismatch between tricuspid reflux degree and tricuspid anmular diameter or pulmonary artery pressure . Tricuspid valve repair shows better early and mid-term outcomes .