title: Different determinants of residual tricuspid regurgitation after tricuspid annuloplasty: comparison of atrial septal defect and mitral valve prolapse.
abstract: We analyzed 20 patients with atrial septal defect (ASD) who underwent tricuspid valve (TV) annuloplasty and ASD closure, 21 patients with mitral valve prolapse (MVP) who underwent mitral valve (MV) and TV annuloplasty, and 20 healthy controls. Severity of tricuspid regurgitation (TR) was assessed by maximal TR jet area/RA area (%TR) using echocardiography before and early after surgery. Before surgery, 2 groups of patients showed significantly greater RA area, TV annulus diameter, RV systolic pressure, and %TR than controls. %TR was significantly decreased after surgery, whereas residual TR was shown in 19% of the MVP group and 25% of the ASD group. Preoperative TV tethering height and %TR were significantly associated with postoperative %TR in the MVP group, whereas preoperative RV fractional area change, RV spherical index, and RV systolic pressure were significantly associated with postoperative %TR in the ASD group. Risk stratification after TV annuloplasty should take the structural abnormality into consideration.
authors.affiliation: Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio, USA.
authors.forename: Manatomo
authors.initials: M
authors.lastname: Toyono
authors.forename: Shota
authors.initials: S
authors.lastname: Fukuda
authors.forename: A Marc
authors.initials: AM
authors.lastname: Gillinov
authors.forename: Gosta B
authors.initials: GB
authors.lastname: Pettersson
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Matsumura
authors.forename: Nozomi
authors.initials: N
authors.lastname: Wada
authors.forename: Tetsuhiro
authors.initials: T
authors.lastname: Yamano
authors.forename: Kunitsugu
authors.initials: K
authors.lastname: Takasaki
authors.forename: Takahiro
authors.initials: T
authors.lastname: Shiota
mesh_terms: D005260:Female; D006344:Heart Septal Defects, Atrial / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008945:Mitral Valve Prolapse / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery*; D012189:Retrospective Studies; D055502:Secondary Prevention; D016896:Treatment Outcome; D014261:Tricuspid Valve / Q000601:surgery*; D014262:Tricuspid Valve Insufficiency / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery*; D014463:Ultrasonography