Predictors of secondary tricuspid regurgitation after left-sided valve replacement.
OBJECTIVE
To evaluate the risk factors of tricuspid regurgitation (TR) after left-sided valve replacement (LSVR) and plan the initial surgical treatment of TR.


METHODS
Two hundred and forty-eight patients, including 217 patients in the LSVR group and 31 patients in the LSVR+DeVega group, were followed up. A retrospective analysis was performed on 14 characteristics in the LSVR group. Variables were used to evaluate predictors of TR progression after single LSVR by either a univariate or multivariate analysis. DeVega's tricuspid annuloplasty was evaluated on progress of TR by univariate analysis.


RESULTS
The mean follow-up was 5.2 +/- 2.9 (range, 3-16) years after surgery. In a univariate analysis, atrial fibrillation, huge left atrium, long time from onset to surgery, tricuspid rheumatic changes, preoperative +2 or +3 TR, the degradation of left ventricular ejection fraction, augmented right atrium, and single mitral valvular disease were significant risk factors for TR development. A multivariate analysis indicated that the four items mentioned above were statistically significant predictors of TR after surgery. The progress of TR in the LSVR+DeVega group was significantly less than in the LSVR group.


CONCLUSIONS
An aggressive repair of accompanying TR should be performed at the time of initial surgery in patients with a huge left atrium, atrial fibrillation, long time from onset to surgery, or tricuspid rheumatic changes. DeVega's tricuspid annuloplasty therefore helps prevent a progression of TR.
Wang
Guohua
G
Department of Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan, 430022, Hubei, PR China.
Sun
Zongquan
Z
Xia
Jiahong
J
Deng
Yongzhi
Y
Chen
Jiajun
J
Su
Gang
G
Ke
Youli
Y