Treatment means _'s treatment of tricuspid stenosis
Tricuspid stenosis (tricuspidstenosis) Rare on clinic, and the most for rheumatism membrane inflammation in the heart one and then offer as a gift and damage, often amalgamate a pathological change of bicuspid valve or aorta, simple tricuspid stenosis is rare. See more women, the overwhelming majority is caused by rheumatic fever, but rheumatism single tricuspid stenosis is extremely rare. As sequela of rheumatic fever, it is similar to mitral stenosis that pathology is changed, namely valve fiber take, increase thick, edge have superfluous living beings grow, three the intersection of valve and mutual adhesion or merge, form the narrow holes of triangle. Pathological change can also prolong and chorde tendinae and papilla skin. But intensity and range of tricuspid valve pathological change are lighter than bicuspid valve, it is rare to merge under the valve, and seldom there is calcium that is deposited. Narrow after taking shape, the obstacle happens when the blood flow flows into the right ventricle from the atrium dextrum, therefore the atrium dextrum is expanded, the pressure rises. Because of the reflux blockage of vena cava, venous pressure is raised for a long time, signs such as intravenous anger one of neck, hepatomegaly, ascites and four limbs edema,etc. appear. The right ventricle withers because of reducing in blood flow volume. When with bicuspid valve pathological change, the right ventricle is very plump.
1,Generally treat the treatment of a disease and should restrain sodium salt from taking in strictly, employ diuretic, can improve symptom and physical sign of extravasated blood of the systemic circulation, especially lighten liver extravasated blood, improve liver function; If symptom is obvious, the average diastolic pressure Damien 0.53- 0.67kPa (4- 5mmHg) of right ventricle ,When being smaller than 1.5- 2.0cm2 with a area of tricuspid valve, can carry on the surgery treatment.
2,Surgery treatment in principle the same as mitral stenosis, but person who close expand, separate skill to be apt to tear valve, lead to the fact, shut off the wholly seriously, have not advocated employing yet at present.
( 1) Cut the skill and suitable for merging, well organized case of valve of simple juncture in the juncture of tricuspid valve. Cut-out atrium dextrum,it down direct-view by knife petal before not cutting respectively and it separate on petal and after petal and integration juncture to separate petal, disengage it into two each leaves. Petal before not cutting with after there merge being easy to be produce is juncture of petal, so should be cautious.
( 2) The tricuspid valve replaces the skill and suitable for the valve and damages the deformity or shuts to the persons who can not be closed completely of cake seriously. The operation is cut-outed by the atrium dextrum. Excise valve, put suture and put artificial step of valve into basically until bicuspid valve replace skill to be same. But should notice:
A ring structure of tricuspid valve is not tough and tensile enough, it needs to take the spacer so as not to tear to wear the cotton-padded mattress type suture which sews a ring;
Can't cross a ring through the position suture of a leaf, so as not to damage and conduct bunch;
Seeing that the apt to take place postoperative thrombus of tricuspid valve, the pressure that and the valve bears and has smaller bicuspid valve position than the aorta one, it is comparatively suitable to replace the artificial living beings one.
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