Prediction of outcome in patients undergoing surgery for severe tricuspid regurgitation following mitral valve surgery and role of tricuspid annular systolic velocity.
This study was performed to identify echocardiographic parameters related to postoperative clinical outcome in patients who undergo surgery for severe tricuspid regurgitation after mitral valve surgery. Eighteen patients (2 men, 16 women; mean age 58 years) were prospectively enrolled. Echocardiographic examinations were performed before and 15 +/- 7 months after surgery. Favorable postoperative clinical outcome was defined as an improvement of > or = 1 in New York Heart Association functional class or a > 25% increase in respiratory variation of inferior vena cava diameter. Operative mortality was 11% (2 of 18). Of the 16 survivors, 9 (56%) achieved favorable postoperative clinical outcomes. Only systolic tricuspid annulus velocity (S'T) was found to be associated with postoperative clinical outcome (favorable vs unfavorable postoperative clinical outcome 12.9 +/- 2.1 vs 9.7+/- 1.7 cm/s, p < 0.05). For S'T < 9.5 cm/s, the sensitivity, specificity, and positive and negative predictive values for predicting an unfavorable postoperative clinical outcome were 67%, 100%, 100%, and 75%, respectively. In conclusion, S(T') can predict postoperative clinical outcomes in these patients.
Kwon
Dong-A
DA
Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
Park
Jin-Shik
JS
Chang
Hyuk-Jae
HJ
Kim
Yong-Jin
YJ
Sohn
Dae-Won
DW
Kim
Ki-Bong
KB
Ahn
Hyuk
H
Oh
Byung-Hee
BH
Park
Young-Bae
YB
Choi
Yun-Shik
YS
D001783:Blood Flow Velocity / Q000502:physiology*; D006348:Cardiac Surgical Procedures / Q000379:methods*; D015150:Echocardiography, Doppler; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000601:surgery*; D011379:Prognosis; D011446:Prospective Studies; D012086:Reoperation; D012720:Severity of Illness Index; D014261:Tricuspid Valve / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000601:surgery; D014262:Tricuspid Valve Insufficiency / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*