title: Assessment of functional tricuspid regurgitation using 320-detector-row multislice computed tomography: risk factor analysis for recurrent regurgitation after tricuspid annuloplasty.
abstract: OBJECTIVE
  Functional tricuspid regurgitation (TR) often develops secondary to left heart disease. Tricuspid annuloplasty (TAP) is usually the treatment of choice for significant TRs, but recurrence of TR after surgery can occur. Previous studies have not clearly demonstrated the cause of the recurrent TR after TAP. By using an electrocardiogram-gated 320-detector-row multislice computed tomography (CT), we sought to delineate the morphologic cause of the incompetent tricuspid valve and identify the risk factors for recurrent TR.
  
  
  METHODS
  From August 2010 to September 2011, 35 patients underwent preoperative CT of the tricuspid valve. The distance between each commissure, the tethering angle of each leaflet, and the tethering height were measured. TAP using a rigid annuloplasty ring was performed in 22 patients. Risk factors for recurrent TR were determined by multivariate analyses.
  
  
  RESULTS
  End-diastolic and end-systolic tricuspid valve annular diameters (TVAD) correlated significantly with preoperative TR severity (R(2), 0.2734-0.4287; P < .05). However, compared with TVAD, tethering angles and height showed stronger correlation with preoperative TR severity (R(2): tethering angles, 0.5769-0.6810; tethering height, 0.6854). Multivariate analysis revealed that tethering height was an independent risk factor of postoperative recurrent TR (P = .0069).
  
  
  CONCLUSIONS
  TVAD, tethering angles, and tethering height correlated significantly with preoperative TR severity. The tethering height of the tricuspid valve showed significant correlation with recurrent TR.
authors.affiliation: Department of Cardiovascular Surgery, Chiba University Graduate of Medicine, Chiba, Japan.
authors.forename: Masashi
authors.initials: M
authors.lastname: Kabasawa
authors.affiliation: Department of Cardiovascular Surgery, Chiba University Graduate of Medicine, Chiba, Japan.
authors.forename: Hiroki
authors.initials: H
authors.lastname: Kohno
authors.affiliation: Department of Cardiovascular Surgery, Chiba University Graduate of Medicine, Chiba, Japan.
authors.forename: Toru
authors.initials: T
authors.lastname: Ishizaka
authors.affiliation: Department of Cardiovascular Surgery, Chiba University Graduate of Medicine, Chiba, Japan.
authors.forename: Keiichi
authors.initials: K
authors.lastname: Ishida
authors.affiliation: Department of Cardiovascular Science and Medicine, Chiba University Graduate of Medicine, Chiba, Japan.
authors.forename: Nobusada
authors.initials: N
authors.lastname: Funabashi
authors.affiliation: Department of Cardiovascular Science and Medicine, Chiba University Graduate of Medicine, Chiba, Japan.
authors.forename: Akihisa
authors.initials: A
authors.lastname: Kataoka
authors.affiliation: Department of Cardiovascular Surgery, Chiba University Graduate of Medicine, Chiba, Japan. Electronic address: matsumg@faculty.chiba-u.jp.
authors.forename: Goro
authors.initials: G
authors.lastname: Matsumiya
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D058385:Cardiac Valve Annuloplasty / Q000009:adverse effects*; D055424:Cardiac-Gated Imaging Techniques / Q000379:methods*; D004562:Electrocardiography; D005260:Female; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects*; D006801:Humans; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D014261:Tricuspid Valve / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000601:surgery*; D014262:Tricuspid Valve Insufficiency / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*