RT Journal Article
SR Electronic
T1 Tricuspid regurgitation severity after atrial septal defect closure or pulmonic valve replacement
JF Heart
JO Heart
FD BMJ Publishing Group Ltd and British Cardiovascular Society
SP 455
OP 461
DO 10.1136/heartjnl-2019-315287
VO 106
IS 6
A1 Agustin C Martin-Garcia
A1 Konstantinos Dimopoulos
A1 Maria Boutsikou
A1 Ana Martin-Garcia
A1 Aleksander Kempny
A1 Rafael Alonso-Gonzalez
A1 Lorna Swan
A1 Anselm Uebing
A1 Sonya V Babu-Narayan
A1 Pedro Luis Sanchez
A1 Wei Li
A1 Darryl Shore
A1 Michael A Gatzoulis
YR 2020
UL http://heart.bmj.com/content/106/6/455.abstract
AB Objectives Cardiac surgery or catheter interventions are nowadays commonly performed to reduce volume loading of the right ventricle in adults with congenital heart disease. However, little is known, on the effect of such procedures on pre-existing tricuspid regurgitation (TR). We assessed the potential reduction in the severity of TR after atrial septal defect (ASD) closure and pulmonic valve replacement (PVR).Methods Demographics, clinical and echocardiographic characteristics of consecutive patients undergoing ASD closure or PVR between 2005 and 2014 at a single centre who had at least mild preoperative TR were collected and analysed.Results Overall, 162 patients (mean age at intervention 41.6±16.1 years, 38.3% male) were included: 101 after ASD closure (61 transcatheter vs 40 surgical) and 61 after PVR (3 transcatheter vs 58 surgical). Only 11.1% received concomitant tricuspid valve surgery (repair). There was significant reduction in the severity of TR in the overall population, from 38 (23.5%) patients having moderate or severe TR preoperatively to only 11 (6.8%) and 20 (12.3%) at 6 months and 12 months of follow-up, respectively (McNemar p<0.0001). There was a significant reduction in tricuspid valve annular diameter (p<0.0001), coaptation distance (p<0.0001) and systolic tenting area (p<0.0001). The reduction in TR was also observed in patients who did not have concomitant tricuspid valve (TV) repair (from 15.3% to 6.9% and 11.8% at 6 and 12 months, respectively, p<0.0001). On multivariable logistic regression including all univariable predictors of residual TR at 12 months, only RA area remained in the model (OR 1.2, 95% CI 1.04 to 1.37, p=0.01).Conclusions ASD closure and PVR are associated with a significant reduction in tricuspid regurgitation, even among patients who do not undergo concomitant tricuspid valve surgery.