Evolution of Tricuspid Regurgitation After Repair of Degenerative Mitral Regurgitation
| Autor: | Philip M. Jones, Nikolaos Tzemos, Usha Manian, Fadi G. Hage, Ali Hage, Michael W.A. Chu |
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| Rok vydání: | 2020 |
| Předmět: |
Male
Pulmonary and Respiratory Medicine medicine.medical_specialty Time Factors medicine.medical_treatment Regurgitation (circulation) 030204 cardiovascular system & hematology Severity of Illness Index 03 medical and health sciences Postoperative Complications 0302 clinical medicine Interquartile range Internal medicine Severity of illness medicine Humans Aged Retrospective Studies Heart Valve Prosthesis Implantation Mitral valve repair Mitral regurgitation business.industry Hazard ratio Mitral Valve Insufficiency Retrospective cohort study Middle Aged Prognosis Tricuspid Valve Insufficiency Treatment Outcome 030228 respiratory system Echocardiography Concomitant Cardiology Mitral Valve Female Surgery Cardiology and Cardiovascular Medicine business Follow-Up Studies |
| Zdroj: | The Annals of Thoracic Surgery. 109:1350-1355 |
| ISSN: | 0003-4975 |
| Popis: | Background The fate of unrepaired tricuspid regurgitation (TR) after mitral valve repair for degenerative mitral regurgitation remains highly debated. The objective of this study was to examine the progress of unrepaired TR after mitral valve repair for degenerative mitral regurgitation, with a particular focus on comparing patients with moderate preoperative TR with those having none or mild preoperative TR. Methods Between 2008 and 2018, 183 consecutive patients (mean age, 61 years [SD, 14]) with severe degenerative mitral regurgitation and less-than-severe TR underwent mitral valve repair alone without concomitant TR repair. They were prospectively followed for a median duration of 3.1 years (interquartile range, 1.6-5.5; maximal duration of 9.4 years). Results At baseline 146 patients (80%) had none or mild TR; 37 patients (20%) had moderate TR. At follow-up 51 patients (30%) had improved TR compared with 28 patients (17%) who had worse TR. At 3 years postoperatively echocardiographic data were available for 82 of 183 patients: 70 (85%) had none or mild TR, 11 (13%) had moderate TR, and 1 (1.2%) had moderate to severe TR. In an exploratory multivariable analysis with limited statistical power, patients with moderate preoperative TR (vs those with none or mild TR) had an association with higher mortality (hazard ratio, 2.8; 95% confidence interval, 0.81-9.4; P = .11). Conclusions After mitral valve repair but without concomitant tricuspid valve repair, a number of patients had progression in their TR. There was a signal of harm in patients having moderate preoperative TR in terms of mortality, but this finding is exploratory and requires investigation. |
| Databáze: | OpenAIRE |
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