Tricuspid annular dynamics before and after tricuspid annuloplasty- three-dimensional transesophageal echocardiography.
BACKGROUND
Little is known about the impact of tricuspid annuloplasty (TAP) on annular dynamics. We assessed tricuspid annular dynamics using 3-D transesophageal echocardiography (3D-TEE) before and after TAP with different types of prosthetic ring.


RESULTS
3D-TEE of the tricuspid valve was acquired in 30 patients (TAP with rigid ring [RR], n=8; TAP with flexible ring [FR], n=10; control, n=12). Tricuspid annular dimensions (circumference, area, annular height, anteroposterior [AP], septolateral [SL] diameter) were measured throughout the cardiac cycle. All postoperative tricuspid annular dimension parameters were significantly reduced by TAP, while the AP/SL ratio was significantly increased (before, 0.96±0.16; after, 1.03±0.06; P<0.05). The difference in annular area between diastole and systole was significantly smaller in the TAP groups (11.6%) than in the control (27.9%, P<0.05). Annular height in the FR patients was significantly lower than in the RR group, while the postoperative AP/SL ratio was lower in the RR than the FR and control groups. Change in annular area was not seen in RR patients, while it was seen in the FR and control groups.


CONCLUSIONS
Annulus motion and shape differ according to the type of prosthetic ring used, although tricuspid regurgitation was well controlled by all types of ring utilized. The present results provide important information for selection of an appropriate prosthetic ring for TAP.
Department of Cardiovascular Surgery, Osaka University Graduate School of Medicine.
Hiroyuki
H
Nishi
Koichi
K
Toda
Shigeru
S
Miyagawa
Yasushi
Y
Yoshikawa
Satsuki
S
Fukushima
Masashi
M
Kawamura
Daisuke
D
Yoshioka
Tetsuya
T
Saito
Takayoshi
T
Ueno
Toru
T
Kuratani
Yoshiki
Y
Sawa
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D058385:Cardiac Valve Annuloplasty; D019560:Echocardiography, Three-Dimensional; D017548:Echocardiography, Transesophageal; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D014261:Tricuspid Valve / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery