title: Criteria for determining the need for surgical treatment of tricuspid regurgitation during mitral valve replacement.
abstract: BACKGROUND
  Tricuspid regurgitation (TR) is common in patients with mitral valve disease; however, there are no straightforward, rapidly determinably criteria available for deciding whether TR repair should be performed during mitral valve replacement. The aim of our retrospective study was to identify a simple and fast criterion for determining whether TR repair should be performed in patients undergoing mitral valve replacement.
  
  
  METHODS
  We reviewed the records of patients who underwent mitral valve replacement with or without (control) TR repair (DeVega or Kay procedure) from January 2005 to December 2008. Preoperative and 2-year postoperative echocardiographic measurements included right ventricular and atrial diameter, interventricular septum size, TR severity, ejection fraction, and pulmonary artery pressure.
  
  
  RESULTS
  A total of 89 patients were included (control, n = 50; DeVega, n = 27; Kay, n = 12). Demographic and clinical characteristics were similar between groups. Cardiac variables were similar between the DeVega and Kay groups. Right atrium and ventricular diameter and ejection fraction were significantly decreased postoperatively both in the control and operation (DeVega + Kay) group (P < 0.05). Pulmonary artery pressure was significantly decreased postoperatively in-operation groups (P < 0.05). Our findings indicate that surgical intervention for TR should be considered during mitral valve replacement if any of the following preoperative criteria are met: right atrial transverse diameter > 57 mm; right ventricular end-diastolic diameter > 55 mm; pulmonary artery pressure > 58 mmHg.
  
  
  CONCLUSIONS
  Our findings suggest echocardiography may be used as a rapid and simple means of determining which patients require TR repair during mitral valve replacement.
authors.affiliation: Department of Cardiovascular Surgery, First Affiliated Hospital of Soochow University, Suzhou, Jiang Su 215006, People's Republic of China.
authors.forename: Jigang
authors.initials: J
authors.lastname: He
authors.forename: Zhenya
authors.initials: Z
authors.lastname: Shen
authors.forename: Yunsheng
authors.initials: Y
authors.lastname: Yu
authors.forename: Haoyue
authors.initials: H
authors.lastname: Huang
authors.forename: Wenxue
authors.initials: W
authors.lastname: Ye
authors.forename: Yinglong
authors.initials: Y
authors.lastname: Ding
authors.forename: Shaolei
authors.initials: S
authors.lastname: Yang
mesh_terms: D000328:Adult; D000368:Aged; D001794:Blood Pressure; D058385:Cardiac Valve Annuloplasty; D003661:Decision Support Techniques; D005260:Female; D005500:Follow-Up Studies; D006325:Heart Atria / Q000000981:diagnostic imaging; D019918:Heart Valve Prosthesis Implantation; D006352:Heart Ventricles / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D011651:Pulmonary Artery / Q000000981:diagnostic imaging / Q000502:physiology; D012189:Retrospective Studies; D012214:Rheumatic Heart Disease / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014262:Tricuspid Valve Insufficiency / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D014463:Ultrasonography