Valvular heart diseasePrediction of Outcome in Patients Undergoing Surgery for Severe Tricuspid Regurgitation Following Mitral Valve Surgery and Role of Tricuspid Annular Systolic Velocity
Section snippets
Study subjects
Eighteen patients with severe TR after mitral valve surgery who underwent surgical correction for TR without concomitant mitral or aortic valve surgery from January 2003 to January 2005 were prospectively enrolled. The mean age was 58 ± 5 years, and 2 patients (11%) were men. The cause of TR in all patients was functional after mitral surgery.
Echocardiographic examination
Before surgery, comprehensive echocardiographic examinations were performed using an Acuson Sequoia (Siemens Medical Solutions USA, Inc., Mountain View,
Patient characteristics and clinical outcomes
The baseline characteristics of patients are listed in Table 1. Two in-hospital deaths occurred (25%), 1 due to right ventricular failure and the other due to sepsis, probably associated with a prolonged indwelling catheter. At follow-up evaluation, 9 patients of 16 survivors showed favorable postoperative clinical outcomes. Among patients with favorable postoperative clinical outcomes, 2 were in NYHA functional class II, 4 were in class III, and 3 were in class IV. Among those with unfavorable
Discussion
Previous studies have shown that concomitant coronary artery disease,5, 6 NYHA functional class,5, 6, 7, 8, 9 previous cardiac surgery,4, 8 symptoms and signs of congestive heart failure,5, 8, 9, 10 male gender,8, 9, 10 and the presence of primary lung disease6 are associated with poor prognoses for those who undergo the surgical correction of TR. In the present study, all patients had undergone previous mitral valve surgery, and no patients had concomitant coronary or lung disease; therefore,
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2022, American Journal of CardiologyCitation Excerpt :However, the present results demonstrate that TV annuloplasty was effective in preventing the development of significant TR, which is an independent predictor of worse survival in general4 and after MV surgery. Because TV annuloplasty in patients with a dilated TV annulus is not associated with incremental risk of mortality, and reoperation of late significant TR is associated with high morbidity and mortality,5 a more widespread use of preventive TV annuloplasty might be justifiable. Large prospective studies are needed to clarify the clinical benefit of preventive TV annuloplasty during MV surgery and to establish selection criteria for patients who may benefit most from preventive TV annuloplasty.
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