title: Persistent tricuspid regurgitation after tricuspid annuloplasty during redo valve surgery affects late survival and valve-related events.
abstract: BACKGROUND
  Long-term survival and incidence of late tricuspid regurgitation (TR) were studied in patients who underwent tricuspid annuloplasty (TAP) during redo valve surgery. METHODS AND RESULTS: We retrospectively analyzed 125 patients (mean age, 64.5±10.4 years) who underwent TAP using suture (n=54, group S) or ring (n=71, group R) implantation during redo surgery in a 20-year period. There was a significant difference in prevalence of preoperative atrial fibrillation (P=0.0199). More group S patients were in New York Heart Association functional class III or IV than group R patients (P=0.0066). Mean follow-up was 6.6±5.3 years. Mortality rate for group S was 9.3%, and for group R, 7.0% (P=0.6508). Survival at 5 and 10 years was 72.2±6.6% vs. 88.1±4.0%, and 66.4±7.3% vs. 61.0±7.2%, respectively (log-rank, P=0.7235). Less than moderate TR (hazard ratio [HR], 0.113; P=0.0198) before discharge was a predictor of late survival. There was no statistically significant difference in freedom from valve-related events (log-rank, P=0.5196). A predictor of freedom from valve-related events was less than moderate TR before discharge (HR 0.428; P=0.0100). It was also a positive predictor of freedom from late TR more than mild (HR 0.070; P<0.0001).
  
  
  CONCLUSIONS
  Less than moderate TR before discharge after TAP during redo valve surgery was an independent risk factor for better long-term outcome.
authors.affiliation: Department of Cardiovascular Surgery, Kobe City Medical Center General Hospital.
authors.forename: Naoto
authors.initials: N
authors.lastname: Fukunaga
authors.forename: Yukikatsu
authors.initials: Y
authors.lastname: Okada
authors.forename: Yasunobu
authors.initials: Y
authors.lastname: Konishi
authors.forename: Takashi
authors.initials: T
authors.lastname: Murashita
authors.forename: Tadaaki
authors.initials: T
authors.lastname: Koyama
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000209:etiology / Q000401:mortality / Q000601:surgery; D058385:Cardiac Valve Annuloplasty; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies; D015996:Survival Rate; D013997:Time Factors; D014262:Tricuspid Valve Insufficiency / Q000401:mortality / Q000601:surgery