An Analysis of the Causes of the Emerging Tricuspid Regurgitation
after Minimally Invasive Transthoracic Closure of the
Perimembranous Ventricular Septal Defects
WAN Hao, DUAN Shu-hua,
ZHOU Cai-ping,
XING Quan-sheng
The Affiliated Women and Children
Hospital of Qingdao University Medical
College, Qingdao Shandong 266011,
China
Abstract：Objective To analyze the cause of changes of emerging tricuspid regurgitation after minimally
invasive transthoracic device closure of perimembranous ventricular septal defects (pmVSD). Methods
281 patients with pmVSD were selected to assess for tricuspid regurgitation with transesophageal
echocardiography during preoperative and postoperative periods. Transthoracic echocardiography was
used postoperatively during the 1-wk, 1-mo, 3-mo, 6-mo, 12-mo, 24-mo, 48-mo, 60-mo follow-up to
evaluate the effectiveness and to assess for any complication emerging after the surgery. Results There
were 19 cases with tricuspid regurgitation with varying degrees of aggravation emerging immediately
after closure. During the follow-ups, in the mild-reflux group, 12 patients’ reflux symptom mitigated;
one case aggravated to mild to moderate reflux. In the mild to moderate reflux group, 2 cases alleviated
to mild reflux; the other case aggravated to moderate reflux. Conclusion The aggravation of tricuspid
regurgitation after minimally invasive transthoracic device closure of pmVSD may be caused by the
occluder oppression on the tricuspid chordae or leaflets, tendons damage resulted fromdelivery sheath,
and abnormal origin of part of the anterior tricuspid valve chordate. Mitigation of tricuspid regurgitation
after surgery may be caused by remodeling of the occluder, which leads to oppressed chordae or leaflets
to restore to the physiological state. Preoperative and postoperative ultrasound allows precise assessment
of the position of tricuspid valve chordae and helps with understanding of the construction of the
structure of defect edge tissues, which provides guidance for selecting the appropriate occluder and thus
reduce or mitigate tricuspid regurgitation and other complications.
万浩，段书华，周彩萍，邢泉生. 膜周部室间隔缺损微创封堵术后新发三
尖瓣反流程度变化的原因分析[J]. 中国医疗设备, 2016, 31(2): 125-127.
WAN Hao, DUAN Shu-hua,
ZHOU Cai-ping,
XING Quan-sheng. An Analysis of the Causes of the Emerging Tricuspid Regurgitation
after Minimally Invasive Transthoracic Closure of the
Perimembranous Ventricular Septal Defects. China Medical Devices, 2016, 31(2): 125-127.
