title: Clinical outcomes after tricuspid valve annuloplasty in addition to mitral valve surgery.
abstract: Current guidelines recommend tricuspid valve annuloplasty (TVP) together with mitral valve surgery in cases of tricuspid annulus dilation (≥40 mm) or functional tricuspid valve regurgitation >2/4. Baseline clinical and echocardiographic data of patients undergoing mitral valve surgery in a single tertiary care hospital between 2007 and 2010 were analyzed. Mortality and heart failure hospitalization data were collected and groups with or without TVP were compared. Patients with TVP (n=89) had similar baseline characteristics compared with patients without (n=86), except for lower right ventricular fractional area change and more concomitant aortic valve surgery. Mortality was higher in the TVP group at 30 days (14% vs 5%; P=.04), but the difference was no longer significant at the end of follow-up. More patients were hospitalized for heart failure in the TVP group (31% vs 17%; hazard ratio, 2.1; 95% confidence interval, 1.1-4.0; P=.05). Right ventricular sphericity index was the only preoperative parameter predicting death or heart failure hospitalizations. In conclusion, patients undergoing TVP in addition to mitral valve surgery are at high risk for early death or subsequent heart failure hospitalizations, which might be partly explained by more complex heart disease. The extent of preoperative right ventricular remodeling may be predictive of adverse outcomes.
authors.affiliation: Department of Cardiology, Ziekenhuis Oost-Limburg, Genk, Belgium.
authors.forename: Gille
authors.initials: G
authors.lastname: Koppers
authors.forename: David
authors.initials: D
authors.lastname: Verhaert
authors.forename: Frederik H
authors.initials: FH
authors.lastname: Verbrugge
authors.forename: Rozette
authors.initials: R
authors.lastname: Reyskens
authors.forename: Herbert
authors.initials: H
authors.lastname: Gutermann
authors.forename: Chris
authors.initials: C
authors.lastname: Van Kerrebroeck
authors.forename: Pieter
authors.initials: P
authors.lastname: Vandervoort
authors.forename: W H Wilson
authors.initials: WH
authors.lastname: Tang
authors.forename: Robert
authors.initials: R
authors.lastname: Dion
authors.forename: Wilfried
authors.initials: W
authors.lastname: Mullens
mesh_terms: D000368:Aged; D001021:Aortic Valve / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery; D001530:Belgium; D058385:Cardiac Valve Annuloplasty / Q000009:adverse effects / Q000379:methods / Q000706:statistics & numerical data; D004108:Dilatation, Pathologic / Q000000981:diagnostic imaging / Q000601:surgery; D004452:Echocardiography / Q000379:methods; D005260:Female; D006333:Heart Failure / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery; D010043:Outcome and Process Assessment, Health Care; D011183:Postoperative Complications / Q000175:diagnosis / Q000453:epidemiology; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D062606:Tertiary Care Centers / Q000706:statistics & numerical data; D016896:Treatment Outcome; D014261:Tricuspid Valve / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery; D014262:Tricuspid Valve Insufficiency / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology / Q000601:surgery; D016276:Ventricular Function