Severe tricuspid regurgitation after mitral valve surgery: the risk factors and results of the aggressive application of prophylactic tricuspid valve repair

Autor: Mitsuru Uenoyama, Takashi Daimon, Yukitoshi Shirakawa, Hirota Kida, Miyoko Hiramatsu, Takashi Yamauchi, Mitsunori Kaneko, Keiwa Kin, Kei Horiguchi, Hiroshi Takano
Jazyk: angličtina
Předmět:
Adult
Male
congenital
hereditary
and neonatal diseases and abnormalities
medicine.medical_specialty
Regurgitation (circulation)
Tricuspid regurgitation
macromolecular substances
030204 cardiovascular system & hematology
Severity of Illness Index
Cardiac Valve Annuloplasty
03 medical and health sciences
0302 clinical medicine
Postoperative Complications
Tricuspid valve repair
Surgical oncology
Risk Factors
Mitral valve
Internal medicine
Medicine
Humans
In patient
cardiovascular diseases
TRICUSPID VALVE REPAIR
Aged
Retrospective Studies
business.industry
General Medicine
Tricuspid annular dilatation
Middle Aged
Tricuspid Valve Insufficiency
medicine.anatomical_structure
nervous system
030228 respiratory system
Preoperative Period
Cardiology
cardiovascular system
Original Article
Female
Surgery
Tricuspid Valve
business
Mitral valve surgery
Dilatation
Pathologic
Zdroj: Surgery Today
ISSN: 0941-1291
DOI: 10.1007/s00595-016-1395-4
Popis: Purpose This study aimed to examine the risk factors for severe postoperative tricuspid regurgitation (TR) in patients undergoing mitral valve surgery. We also studied the effects of prophylactic tricuspid valve repair (TVR) on severe postoperative TR. Methods We retrospectively studied 125 patients without severe TR who underwent mitral valve surgery from 1987 to 2006. Patients did not undergo TVR before 1998 (the early period, n = 54). In 1998 (the late period, n = 71), patients with a preoperative tricuspid annular diameter of ≥35 mm underwent TVR using an annuloplasty ring (n = 52). Results In the analysis of the early period, the rates of freedom from severe TR at 10 and 20 years after surgery were 76 and 59 %, respectively. A multivariate analysis identified moderate preoperative TR as a significant risk factor for severe TR. In the late period, none of the 52 patients who underwent TVR developed severe TR. However, 4/19 patients who did not undergo TVR developed severe TR, and all of these four patients had a preoperative tricuspid annular diameter of ≤35 mm. Conclusions Moderate preoperative TR is a significant risk factor for severe postoperative TR in patients undergoing mitral valve surgery. The aggressive application of TVR can prevent severe postoperative TR; however, tricuspid annular dilatation might not be a good indicator for TVR.
Databáze: OpenAIRE
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