title: Tricuspid regurgitation after mitral valve repair for degenerative mitral regurgitation.
abstract: OBJECTIVE
  We examined changes of TR (tricuspid regurgitation) after mitral valve repair for degenerative mitral regurgitation (MR) and investigated their contributing parameters.
  
  
  METHODS
  We divided 205 patients undergoing mitral valve repair for degenerative MR into 3 groups: up-grade (n = 65), down-grade (n = 29), and no-change (n = 111) of TR during postoperative follow-up. Preoperative, immediate postoperative, and mid-term postoperative parameters included MR grade, right ventricular (RV) pressure, RV Tei index, left ventricular Tei index, and presence of atrial fibrillation.
  
  
  RESULTS
  Preoperative incidence of atrial fibrillation in the down-grade group was lower (7%) than those in the other groups (37% and 34%). In the immediate postoperative stage, the TR grade of the up-grade group was significantly lower (p <0.001) and RV Tei index of the downgrade group was significantly lower (p = 0.049). In mid-term postoperative stage, the TR grade (p <0.001) and RV Tei index (p = 0.034) of the down-grade group were significantly lower, and the MR up-grade in the TR up-grade group was significantly frequent (p = 0.008).
  
  
  CONCLUSIONS
  TR became deteriorated even after the operation in about 30% and remained unchanged in about 50%. The RV Tei index can be a reliable parameter to predict postoperative improvement of TR. The postoperative MR up-grade was related to the TR up-grade.
authors.affiliation: Department of Cardiovascular Surgery, Kagoshima University Graduate School of Medical and Dental Sciences.
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Ueno
authors.forename: Ryuzo
authors.initials: R
authors.lastname: Sakata
authors.forename: Yoshiya
authors.initials: Y
authors.lastname: Shigehisa
authors.forename: Hideaki
authors.initials: H
authors.lastname: Kanda
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Hisashi
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Yamamoto
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Imoto
mesh_terms: D000368:Aged; D005260:Female; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D058386:Mitral Valve Annuloplasty / Q000009:adverse effects; D008944:Mitral Valve Insufficiency / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014262:Tricuspid Valve Insufficiency / Q000175:diagnosis / Q000503:physiopathology*