Phẫu thuật nội soi điều trị bệnh lý van ba lá tại Trung tâm Tim mạch, Bệnh viện E

Abstract

Background. Tricuspid regurgitation is one of the most common heart valve diseases, affecting 65-85% of the population. Primary tricuspid regurgitation has causes in the tricuspid valve including rheumatic, degenerative, congenital, infectious, etc. Secondary tricuspid regurgitation is more common, associated with right ventricular dysfunction, dilated annulus. valves, often secondary to left-sided valve disease (especially mitral valve disease), atrial fibrillation, and pulmonary hypertension. Traditional sternal open surgery has the advantage of being spacious and convenient for technical manipulations, but the method still has many traumas and risks of sternum inflammation. Endoscopic surgery avoids opening the sternum with the advantages of minimizing trauma, eliminating sternitis, being more aesthetic is becoming a trend and is increasingly applied in cardiovascular surgery.
 Aims: Evaluation of early and medium-term results of endoscopic surgery for tricuspid valve disease at cardiovascular center, E Hospital
 Method. Cross-sectional descriptive study, data were collected retrospectively and prospectively
 Result. From January 2020 to December 2021, we studied 42 patients undergoing endoscopic surgery for tricuspid valve disease, including 13 men (31%), 29 women (69%). Average age is 53.98±12.51 years. The number of patients with tricuspid valve repair and mitral valve replacement surgery was 34 patients, the number of patients with tricuspid valve repair after mitral valve replacement surgery was 4 patients, there were 2 patients with severe tricuspid regurgitation due to infective endocarditis . There was 1 patient with tricuspid valve repair combined with atrial septal defect patching. Immediately after surgery, the proportion of patients with no regurgitation or mild regurgitation of the tricuspid valve was 35 patients (83.3%), moderate regurgitation had 6 patients (14.3%), severe regurgitation had 1 patient (2.4%) ), 41 patients (97.6%) were discharged from hospital, 1 patient (2.4%) died early after surgery. The longest follow-up time was 17 months, the shortest was 6 months, the results were no longer tricuspid regurgitation or mild regurgitation in 37 patients (90.2%), moderate regurgitation in 4 patients (9.8%), there aren’t patients with severe regurgitation of the tricuspid valve or late death.
 Conclusion. Endoscopic surgery for the treatment of tricuspid valve disease has good results, aesthetics, few complications.