Determinants of Late Tricuspid Regurgitation After Aortic-Mitral Double Valve Replacement.
The aims of this study are to evaluate the long-term outcomes of double valve replacement (aortic and mitral valves) and to investigate the determinants of late tricuspid regurgitation (TR). A total of 239 consecutive patients who underwent double valve replacement were enrolled. Valve pathology was rheumatic in 86.6% (207/239) and degenerative in 13.4% (32/239) of patients. Among these patients, 116 patients underwent concomitant tricuspid annuloplasty, and follow-up was completed for all 239 patients (mean = 7.3 ± 4.1, maximum = 15.9 years). We used propensity score matching to match 67 patients without tricuspid annuloplasty to the 114 patients who underwent annuloplasty. There was 1 in-hospital death and 9.7% (23/238) of patients experienced late cardiac-related mortality. Analysis of aortic valves indicated that the transprosthetic mean pressure gradient increased with time (13.4 ± 5.2 vs 15.4 ± 9.0 mm Hg, p = 0.002). Aortic transprosthetic mean pressure gradient increased more notably in woman and was associated with late TR (odds ratio 1.1, p = 0.010). In patients with mild TR, those who underwent tricuspid valve repair were less likely to experience a cardiac-related death within 10 years of surgery (hazards ratio 6.1, p = 0.036).
Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Dong Seop
DS
Jeong
Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. Electronic address: pwpark@skku.edu.
Pyo Won
PW
Park
Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Kiick
K
Sung
Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Wook Sung
WS
Kim
Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Young Tak
YT
Lee
D001021:Aortic Valve / Q000000981:diagnostic imaging / Q000601:surgery*; D018450:Disease Progression; D015150:Echocardiography, Doppler; D005260:Female; D005500:Follow-Up Studies; D006349:Heart Valve Diseases / Q000601:surgery; D006350:Heart Valve Prosthesis / Q000009:adverse effects*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000000981:diagnostic imaging / Q000601:surgery*; D011183:Postoperative Complications; D016016:Proportional Hazards Models; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D013997:Time Factors; D014262:Tricuspid Valve Insufficiency / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology