16 Management of tricuspid valve regurgitation in congenital heart disease: a single centre experience

Abstract

VC > 0.5cm; PISA > 0.9cm but continuous wave of MR jet not done; Large (> 6cm) holosystolic jet wrapping around left atrium; Peak E wave velocity > 150cm/s.Results MR was observed in 294/1000 patients (29.4%) post-MI, graded as mild (76%), moderate (21%) and severe (3%).Based on MR characteristics alone (not including LVEF), the number of patients fulfilling MITRA-FR and COAPT eligibility criteria were 23 (7.8% of all IMR) and 24 (8.1% of all IMR) respectively. Both groups had a similar ratio of moderate:severe MR (74:26% vs 75:25%), EROA (0.34+/-0.13cm2 vs 0.35+/-0.13cm2), VC (0.6+/-0.2cm vs 0.6+/-0.2cm), RVol (52+/-24ml vs 51+/-25ml), indexed LA volume (LAVi) (54+/-20ml/m2 vs 51+/-20ml/m2), indexed LV end-diastolic volume (LVEDVi) (62+/-17ml/m2 vs 63+/-18ml/m2), LVEF (48+/-13% vs 47+/-13%) and mortality (MITRA-FR: 23% vs COAPT: 29%, p=0.9243).After including LVEF as a criterion, the number of patients eligible for MITRA-FR and COAPT were just 5 (1.7% of all IMR) and 14 (4.7% of all IMR) respectively. As expected, COAPT patients had a higher mean LVEF (MITRA-FR: 33% vs COAPT: 40%; p=0.077). Both groups remained similar with respect to ratio of moderate:severe MR (60:40% vs 64:36%), EROA (0.40+/-0.13 vs 0.38+/-0.15cm2), VC (0.6 +/-0.2cm vs 0.6+/-0.2cm), LAVi (56+/-20ml/m2 vs 50+/-19ml/m2), LVEDVi (69+/-25ml/m2 vs 67+/-19ml/m2) and mortality (MITRA-FR: 40% vs COAPT: 35%). Conclusion. Post-acute MI, more patients with IMR met COAPT criteria (4.7%) than MITRA-FR echocardiographic criteria (1.7%) however both cohorts had similarly high mortality. . Notwithstanding the difference in LVEF, MITRA-FR and COAPT echo criteria identified almost identical cohorts post-MI.