Long-term echocardiographic follow-up of untreated 2+ functional tricuspid regurgitation in patients undergoing mitral valve surgery

Kusajima, K; Fujita, Tomoyuki; Hata, Hiroyuki; Shimahara, Yusuke; Miura, Sayaka; Kobayashi, Junjiro

doi:10.1093/icvts/ivw065

Cited by 22 publications

(18 citation statements)

References 26 publications

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“…A study by Hata et al 17) revealed that older age was independent risk factor of recurrent moderate-to-severe TR. Kusajima et al 7) reported that age has an independent but minor impact on TR progression, with an OR of 1.1. Similarly, the effect of age was minimal in our study, with an OR of 1.036.…”

Section: Discussionmentioning

confidence: 99%

“…6) Thus, extensive studies were performed to evaluate the risk factors for late TR progression, such as age, female gender, atrial fibrillation, left ventricular dysfunction, and tricuspid annular diameter index. [7][8][9] However, there were scare evidence that investigate different surgical procedure, MVR or MVr, that affects the likelihood of TR progression. The present study aims to compare the influence of MVR versus MVr on the late functional TR development, based on mid-term follow-up and echocardiographic data in MVR or MVr patients with preoperative no to trivial TR.…”

Section: Introductionmentioning

confidence: 99%

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Comparison of Mitral Valve Repair versus Replacement for the Progression of Functional Tricuspid Regurgitation

Gao

Zhuang

et al. 2020

ATCS

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Background: Function tricuspid regurgitation (TR) is frequently observed in patients undergoing mitral valve surgery. It is unclear that mitral valve repair (MVr) or mitral valve replacement (MVR) has influence on the likelihood of late TR progression. Methods: This study included 193 patients with degenerative mitral valve disease who underwent either MVr or MVR. Detailed preoperative materials, follow-up information, and echocardiographic data were collected and statistically analyzed. Results: At 6 and 12 months postoperatively, MVR patients were more likely to have New York Heart Association (NYHA) class III or IV symptoms than MVr patients (6 mo: 15.2% vs 5.0%, 12 mo: 13.0% vs 4.0%, both P <0.05). At 24 months, the incidence of Grade 1+ TR was significantly higher in MVR patients than MVr patients (25.0% vs 12.9%, P <0.05). In univariate analysis, age (odds ratio [OR] = 1.036, P = 0.036), MVR (OR = 2.256, P = 0.033), and preoperative TR area (TRA; OR = 1.541, P = 0.047) were significant predictors for TR progression. In multivariate logistics analysis, only MVR was independently risk factor (P = 0.006). Subsequently, patients were divided into tricuspid valve repair (TVr) group and untreated group. In both subgroups, MVR patients were associated with significantly larger TRA (P <0.01). Conclusion: MVR was an independent risk factor for TR progression, whether tricuspid valve was treated or not.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Comparison of Mitral Valve Repair versus Replacement for the Progression of Functional Tricuspid Regurgitation

Gao

Zhuang

et al. 2020

ATCS

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“…11 However, if moderate or severe TR left untreated, TR may persist or even worsen after mitral valve surgery, leading to progressive heart failure and death. 12 , 13 In addition, reoperation for residual TR carries significant risks and may impose a poor prognosis. 14 , 15 , 16 It has, therefore, been recommended by some experts that a more aggressive approach should be taken in cardiac surgery patients with concomitant TR.…”

Section: Discussionmentioning

confidence: 99%

“… 14 , 15 , 16 It has, therefore, been recommended by some experts that a more aggressive approach should be taken in cardiac surgery patients with concomitant TR. 7 , 12 , 13 , 17 …”

Section: Discussionmentioning

confidence: 99%

Tricuspid valve repair with Dacron band versus DeVega or segmental annuloplasty. Hospital outcome and short term results

Abdelgawad¹,

Ramadan²,

Arafat³

et al. 2017

The Egyptian Heart Journal

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BackgroundThe purpose of this study was to compare the hospital outcome and short term results of tricuspid valve (TV) repair with three repair techniques for functional tricuspid regurgitation (TR), namely, flexible Dacron band, DeVega and segmental annuloplasty.MethodsA total of 60 patients underwent TV repair at National Heart Institute from January 2013 to November 2014, of which 20 had DeVega procedure (DV), 20 had a segmental annuloplasty (SA) procedure and 20 had a Dacron band (DB) procedure. Concomitant procedures done for rheumatic left sided valve pathology consisted of mitral valve replacement in 70% of patients, and double valve replacement in 30% of patients. Clinical and echocardiographic follow-up data were obtained. Follow-up was 100% complete and was concluded after one year.ResultsAll demographic criteria and preoperative characteristics of the three studied groups were comparable except for preoperative right ventricular (RVEDD) size that was significantly bigger in Dacron band group as compared to the other two groups (3.18 ± 0.43 cm compared to 3.00 ± 0.33 cm (DV) and to 2.88 ± 0.35 cm (SA), p value of (0.045)). Similarly, all operative and postoperative criteria were comparable among the study groups. Noticeably, (RVEDD) size remodeled better postoperatively in (DB) group as compared to the other two groups, (2.54 ± 0.26 cm compared to 2.83 ± 0.311 cm (DV) and to 2.72 ± 0.29 cm (SA), mean difference values were group (0.64 ± 0.47 cm) for (DB) compared to (0.18 ± 0.29 cm) for (DV) or to (0.16 ± 0.45 cm) for (SA) with p value of 0.000. The majority of patients in each group did not have tricuspid regurgitation (TR) or mild degree (+1) of (TR) on discharge. After one year of follow-up, most of the patient had either no regurgitation or grade (+1 TR). Two patients (10%) in DV group and one patient (5%) in SA group had (+3 TR). There was no statistical significance in the incidence of hospital mortality, only one patient died in DB and one in DV group (5%) and no death happened after hospital mortality for the three groups after one year.ConclusionsThe three techniques are options to repair the tricuspid valve, however, placement of Dacron band in patients undergoing tricuspid valve repair is associated with better RV remodelling, and hence, a probable better right ventricular performance and better outcome of repair is expected. A higher number of patients are needed with longer follow up period to appreciate the effect on survival and rate of freedom from tricuspid regurgitation and re-intervention.

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“…years in patients with mild preoperative TR, when the TR was not surgically treated. 13 Similarly, Jeong et al recently examined changes in TR after AVR for AS and found that functional TR did not improve in half of the patients with mild or moderate preoperative TR. 14 In the present study, approximately one-third of the patients in the TR group developed late significant TR during follow-up.…”

Section: Disclosuresmentioning

confidence: 98%

Definitive Determinant of Late Significant Tricuspid Regurgitation After Aortic Valve Replacement

Yajima

Yoshioka

Toda

et al. 2018

Circ J

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Long-term echocardiographic follow-up of untreated 2+ functional tricuspid regurgitation in patients undergoing mitral valve surgery

Abstract: Although untreated, 2+ TR significantly improved after mitral valve surgery, it then progressed again in the mid- to long term. Therefore, concomitant TVS should be considered in patients with 2+ TR who have dilated tricuspid annulus or atrial fibrillation, if feasible.

Cited by 22 publications

References 26 publications

Comparison of Mitral Valve Repair versus Replacement for the Progression of Functional Tricuspid Regurgitation

Comparison of Mitral Valve Repair versus Replacement for the Progression of Functional Tricuspid Regurgitation

Tricuspid valve repair with Dacron band versus DeVega or segmental annuloplasty. Hospital outcome and short term results

Definitive Determinant of Late Significant Tricuspid Regurgitation After Aortic Valve Replacement

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