三尖瓣关闭不全的外科处理ppt课件.pptxVIP

三尖瓣关闭不全的外科处理;The tricuspid valve: a neglected valvular lesion;History;Tricuspid anatomy;Tricuspid physiology;Mechanisms of significanttricuspid regurgitation;Stages of primary and functional TR(Stage A-B) ;Stages of primary and functional TR(Stage C-D) ;Indications of TR Surgery;Indications of TR Surgery;How to deal with the tricuspid valve? A myriad of possibilities;Valve repair – Annuloplasty;De Vega annuloplasty;Classical De Vega annuloplasty;Why we need Annuloplasty rings;Annuloplasty rings;Biodegradable ring;Biodegradable ring;Tricuspid valve replacement;TVR OR TVP?;Rheumatic heart disease;Two groups according to tricuspid valve surgery Repair n = 18 (38.3%) Replacement n = 29 (61.7%);;;;;TRICUSPID REPAIR De Vega annuloplasty (8 pts) Duran ring annuloplasty (10 pts) Commissurotomy (2 pts);Follow-up Complete follow-up 97.8% Mean follow-up 16.2 years Range 1 month – 33 years;;;Survival;Freedom from reoperation;TVR n = 29 Alive 20.7% Class I 2 Class II 3 Class III 1;Isolated tricuspid valve surgery with normal functioning left side valve occurs after mitral and/or aortic valve surgery Isolated tricuspid valve surgery has a high early and late mortality due to cardiac causes Tricuspid valve replacement entails a worse result comparing with tricuspid valve repair;Other options;Conclusions