title: Right heart chamber geometry and tricuspid annulus morphology in patients undergoing mitral valve repair with and without tricuspid valve annuloplasty.
abstract: According to current recommendations, patients could benefit from tricuspid valve (TV) annuloplasty at the time mitral valve (MV) surgery if tricuspid regurgitation is severe or if tricuspid annulus (TA) dilatation is present. Therefore, an accurate pre-operative echocardiographic study is mandatory for left but also for right cardiac structures. Aims of this study are to assess right atrial (RA), right ventricular (RV) and TA geometry and function in patients undergoing MV repair without or with TV annuloplasty. We studied 103 patients undergoing MV surgery without (G1: 54 cases) or with (G2: 49 cases) concomitant TV annuloplasty and 40 healthy subjects (NL) as controls. RA, RV and TA were evaluated by three-dimensional (3D) transthoracic echocardiography. Comparing the pathological to the NL group, TA parameters and 3D right chamber volumes were significantly larger. RA and RV ejection fraction and TA% reduction were lower in pathological versus NL, and in G2 versus G1. In pathological patients, TA area positively correlated to systolic pulmonary pressure and negatively with RV and RA ejection fraction. Patients undergoing MV surgery and TV annuloplasty had an increased TA dimensions and a more advanced remodeling of right heart chambers probably reflecting an advanced stage of the disease.
authors.affiliation: Centro Cardiologico Monzino IRCCS, Via Parea 4, 20138, Milan, Italy. gtamborini@ccfm.it.
authors.forename: Gloria
authors.initials: G
authors.lastname: Tamborini
authors.affiliation: Centro Cardiologico Monzino IRCCS, Via Parea 4, 20138, Milan, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Fusini
authors.affiliation: Centro Cardiologico Monzino IRCCS, Via Parea 4, 20138, Milan, Italy.
authors.forename: Manuela
authors.initials: M
authors.lastname: Muratori
authors.affiliation: Centro Cardiologico Monzino IRCCS, Via Parea 4, 20138, Milan, Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Gripari
authors.affiliation: Centro Cardiologico Monzino IRCCS, Via Parea 4, 20138, Milan, Italy.
authors.forename: Sarah
authors.initials: S
authors.lastname: Ghulam Ali
authors.affiliation: Centro Cardiologico Monzino IRCCS, Via Parea 4, 20138, Milan, Italy.
authors.forename: Cesare
authors.initials: C
authors.lastname: Fiorentini
authors.affiliation: Centro Cardiologico Monzino IRCCS, Via Parea 4, 20138, Milan, Italy.
authors.forename: Mauro
authors.initials: M
authors.lastname: Pepi
mesh_terms: D000368:Aged; D062186:Arterial Pressure; D016280:Atrial Function, Right; D064752:Atrial Remodeling; D058385:Cardiac Valve Annuloplasty / Q000009:adverse effects; D016022:Case-Control Studies; D019560:Echocardiography, Three-Dimensional; D005260:Female; D006325:Heart Atria / Q000000981:diagnostic imaging / Q000503:physiopathology*; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D008944:Mitral Valve Insufficiency / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D008945:Mitral Valve Prolapse / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D015588:Observer Variation; D011237:Predictive Value of Tests; D011651:Pulmonary Artery / Q000503:physiopathology; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014261:Tricuspid Valve / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D014262:Tricuspid Valve Insufficiency / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D016278:Ventricular Function, Right; D020257:Ventricular Remodeling
keywords: Cardiac surgery; Echocardiography; Tricuspid regurgitation; Tricuspid valve repair
references.citation: Circulation. 2010 Oct 12;122(15):1505-13
references.pmid: 20876436
references.citation: Eur J Echocardiogr. 2009 Jun;10 (4):477-84
references.pmid: 19482963
references.citation: Ann Thorac Surg. 2005 Jan;79(1):127-32
references.pmid: 15620928
references.citation: J Am Coll Cardiol. 2004 Feb 4;43(3):405-9
references.pmid: 15013122
references.citation: J Am Soc Echocardiogr. 2004 May;17 (5):443-7
references.pmid: 15122184
references.citation: Am Heart J. 2002 Sep;144(3):524-9
references.pmid: 12228791
references.citation: J Heart Valve Dis. 2010 Jul;19(4):412-9
references.pmid: 20845886
references.citation: Circulation. 2006 Jul 11;114(2):143-9
references.pmid: 16818811
references.citation: Eur Heart J. 2013 Mar;34(11):844-52
references.pmid: 23335604
references.citation: Am J Cardiol. 2008 Aug 15;102(4):499-505
references.pmid: 18678314
references.citation: Circulation. 2006 Jul 4;114(1 Suppl):I492-8
references.pmid: 16820625
references.citation: Circ Cardiovasc Imaging. 2013 Sep;6(5):700-10
references.pmid: 23811752
references.citation: J Thorac Cardiovasc Surg. 2012 Mar;143(3):632-8
references.pmid: 22244561
references.citation: J Cardiothorac Vasc Anesth. 2013 Aug;27(4):639-46
references.pmid: 23725682
references.citation: Eur Heart J. 2013 Jul;34(25):1875-85
references.pmid: 23303656
references.citation: Circulation. 2011 Jun 7;123(22):2542-51
references.pmid: 21646505
references.citation: J Am Coll Cardiol. 2009 Feb 3;53(5):401-8
references.pmid: 19179197
references.citation: J Thorac Cardiovasc Surg. 2013 Aug;146(2):278-84
references.pmid: 22871566
references.citation: J Am Coll Cardiol. 2007 Oct 23;50(17 ):1668-76
references.pmid: 17950149
references.citation: J Am Soc Echocardiogr. 1994 Jan-Feb;7(1):20-6
references.pmid: 8155330
references.citation: J Am Soc Echocardiogr. 2010 Feb;23 (2):109-15
references.pmid: 20152691
references.citation: Circulation. 1982 Sep;66(3):665-71
references.pmid: 7094278
references.citation: J Thorac Cardiovasc Surg. 2011 Aug;142(2):308-13
references.pmid: 21163499
references.citation: Am J Cardiol. 2014 Mar 15;113(6):995-1000
references.pmid: 24461768
references.citation: Interact Cardiovasc Thorac Surg. 2012 May;14 (5):580-4
references.pmid: 22345059
references.citation: JACC Cardiovasc Imaging. 2010 Jan;3(1):10-8
references.pmid: 20129525
references.citation: Int J Cardiovasc Imaging. 2007 Dec;23 (6):717-24
references.pmid: 17318363
references.citation: Curr Cardiol Rep. 2011 Jun;13(3):242-9
references.pmid: 21365261
references.citation: J Am Coll Cardiol. 2014 Jun 10;63(22):e57-185
references.pmid: 24603191
references.citation: Eur J Echocardiogr. 2010 Oct;11(9):778-85
references.pmid: 20488814
references.citation: J Am Coll Cardiol. 2012 Feb 21;59(8):703-10
references.pmid: 22340261
references.citation: Arch Cardiovasc Dis. 2013 Aug-Sep;106(8-9):419-22
references.pmid: 23906678
references.citation: J Am Coll Cardiol. 2014 Dec 23;64(24):2633-42
references.pmid: 25524343