Mild to moderate functional tricuspid regurgitation: retrospective comparison of surgical and conservative treatment.
Background. Unoperated severe tricuspid regurgitation (TR) leads to the right ventricle (RV) failure. We wanted to determine if there was near-term postoperative progression of noncorrected mild to moderate functional TR in patients who underwent mitral valve surgery for chronic significant mitral regurgitation (MR) and if RV size and function were affected. Methods and Results. We compared two groups of patients retrospectively. In the first group (TVA+, n = 45), tricuspid valve annuloplasty (TVA) had been performed in conjunction with either mitral valve replacement (MVR) or mitral valve repair (MVP). The second group (TVA-, n = 22) underwent MVP or MVR without TVA. TVA+ group revealed a significant decrease in TR and right ventricle diameter. In the TVA- group, 7 patients (32%) showed a significant progression, by one or more grades, of noncorrected TR together with dilatation and decreased ejection fraction of the right ventricle. Conclusions. Tricuspid annuloplasty performed concurrently with MVP or MVR can prevent subsequent progression of tricuspid regurgitation along with right ventricular dilatation and systolic dysfunction in the near-term postoperative period.
Smíd
Michal
M
Department of Internal Medicine, University Hospital and Medical Faculty Pilsen, Charles University Prague, alej Svobody 80, 304 60 Pilsen, Czech Republic.
Cech
Jakub
J
Rokyta
Richard
R
Roucka
Patrik
P
Hájek
Tomás
T
J Thorac Cardiovasc Surg. 1995 Jun;109(6):1035-41
7776666
J Am Coll Cardiol. 2006 Aug 1;48(3):e1-148
16875962
Ann Thorac Surg. 2003 Jun;75(6):1826-8
12822623
Ann Thorac Surg. 2005 Jan;79(1):127-32
15620928
Ann Thorac Surg. 2005 Sep;80(3):845-50
16122441
Circulation. 2005 Aug 30;112(9 Suppl):I453-7
16159862
J Thorac Cardiovasc Surg. 1995 Sep;110(3):672-9
7564433
Ann Thorac Surg. 1996 Jun;61(6):1775-80
8651783
Cardiovasc Surg. 2001 Aug;9(4):369-77
11420162
Eur Heart J. 2007 Jan;28(2):230-68
17259184
Ann Thorac Surg. 2004 May;77(5):1607-14
15111151
J Thorac Cardiovasc Surg. 2004 Mar;127(3):674-85
15001895
J Thorac Cardiovasc Surg. 1999 Mar;117(3):463-71
10047648
J Heart Valve Dis. 1999 Jan;8(1):57-62
10096483
J Am Coll Cardiol. 1994 Aug;24(2):446-53
8034882