title: Prevalence of significant tricuspid regurgitation in patients with successful percutaneous mitral valvuloplasty for mitral stenosis: results from 12 years' follow-up of one centre prospective registry.
abstract: BACKGROUND
  Percutaneous mitral valvuloplasty (PMV) is an attractive therapeutic option for mitral stenosis (MS).
  
  
  OBJECTIVE
  To investigate the incidence and development of tricuspid regurgitation (TR) long after successful PMV.   DESIGN, PATIENTS AND INTERVENTIONS:  A prospective cohort of 299 patients with symptomatic MS who underwent successful PMV as first-line treatment between 1988 and 2010.
  
  
  METHODS
  One tertiary university hospital.
  
  
  METHODS
  Significant TR, defined as a grade ≥3 on echocardiographic analysis.
  
  
  RESULTS
  Although most TR regressed in these patients immediately after the procedure, 56 patients developed significant TR during follow-up (median 12 years, IQR 8.0-18.0 years). The cumulative incidence of significant TR increased time-dependently (9.4%, 19.8% and 35.2% at 8, 12 and 18 years of follow-up, respectively). Atrial fibrillation (AF) and TR grade ≥2 before PMV were found to be independent predictors of significant TR (HR (95% CI) 3.049 (1.169 to 7.949) and 3.016 (1.303 to 6.982), p=0.023 and 0.010 for pre-PMV AF and pre-PMV TR grade ≥2, respectively). Even after, exclusion of patients with significant TR at baseline, pre-PMV TR grade ≥2 and AF remained important factors of de novo TR development. Mitral valve restenosis was also associated with late significant TR development.
  
  
  CONCLUSIONS
  Significant TR after successful PMV in patients with MS is not uncommon long after PMV. TR development is closely associated with mitral valve restenosis. More attention should be paid during long-term follow-up to TR development in patients with MS who have significant pre-PMV TR and/or AF.
authors.affiliation: Cardiovascular Center, Seoul National University Hospital, Seoul, Korea.
authors.forename: Seung-Pyo
authors.initials: SP
authors.lastname: Lee
authors.forename: Hyung-Kwan
authors.initials: HK
authors.lastname: Kim
authors.forename: Kyung-Hee
authors.initials: KH
authors.lastname: Kim
authors.forename: Ji-Hyun
authors.initials: JH
authors.lastname: Kim
authors.forename: Hyo Eun
authors.initials: HE
authors.lastname: Park
authors.forename: Yong-Jin
authors.initials: YJ
authors.lastname: Kim
authors.forename: Goo-Yeong
authors.initials: GY
authors.lastname: Cho
authors.forename: Dae-Won
authors.initials: DW
authors.lastname: Sohn
mesh_terms: D000328:Adult; D063126:Balloon Valvuloplasty / Q000009:adverse effects* / Q000379:methods; D006328:Cardiac Catheterization; D004452:Echocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008946:Mitral Valve Stenosis / Q000601:surgery*; D011183:Postoperative Complications; D015995:Prevalence; D011446:Prospective Studies; D056910:Republic of Korea / Q000453:epidemiology; D013997:Time Factors; D014262:Tricuspid Valve Insufficiency / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000209:etiology