scholarly journals Four-dimensional geometric assessment of tricuspid annulus movement in early functional tricuspid regurgitation patients indicates decreased longitudinal flexibility

2013 ◽  
Vol 16 (6) ◽  
pp. 743-749 ◽  
Author(s):  
Satoru Maeba ◽  
Takahiro Taguchi ◽  
Hirofumi Midorikawa ◽  
Megumu Kanno ◽  
Taijiro Sueda
Keyword(s):  
Tricuspid Regurgitation ◽  
Tricuspid Annulus ◽  
Functional Tricuspid Regurgitation ◽  
Longitudinal Flexibility

Evolution of Tricuspid Regurgitation after Mitral Valve Surgery for Patients with Moderate-or-Less Functional Tricuspid Regurgitation

2012 ◽  
Vol 15 (3) ◽  
pp. 121 ◽  
Author(s):  
Kai-hu Shi ◽  
Hai-yang Xuan ◽  
Fei Zhang ◽  
Sheng-song Xu ◽  
Jun-xu Wu ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Mitral Valve ◽  
Postoperative Period ◽  
Tricuspid Regurgitation ◽  
Mitral Valve Surgery ◽  
Tricuspid Annulus ◽  
Lower Survival ◽  
Functional Tricuspid Regurgitation ◽  
The Impact

<p><b>Objectives:</b> The purpose of this study was to evaluate the impact of moderate-or-less functional tricuspid regurgitation (TR) treatment on the clinical outcome of patients with mitral valve (MV) surgery.</p><p><b>Methods:</b> From October 2001 to January 2005, 167 patients in our hospital with MV surgery and without organic tricuspid valve (TV) disease or pulmonary hypertension (PH) showed moderate-or-less functional TR preoperatively, and 41.9% of these patients were treated with TR (group T), compared with 58.1% untreated with TR (group no-T). According to tricuspid annulus dimension (TAD)/body surface area (BSA), these 167 patients were further divided into another 2 groups (A and B): group A (70 patients) represented TAD/BSA ? 21 mm/m2 with 32 patients from group T and 38 from group no-T, and group B (97 patients) represented TAD/BSA > 21 mm/m2 with 38 patients from group T and 59 patients from group no-T. There was no statistical difference in preoperative and operative variables between the 2 groups. Meanwhile, among the 167 patients with MV surgery, 157 patients were replaced with MV and 10 patients were repaired with MV, and De Vega technique was constantly used for TR treatment. All the results were estimated by multivariate analysis.</p><p>Results: The median follow-up time was 63 months (25th and 75th percentiles are 53 and 94 months, respectively); 30-day mortality was 3% (1.4% in group T versus 4.1% in group no-T; <i>P</i> = .31). Adjusted 5-year survival was 70.7% (66.6%-80.4%) with 85.3% (83.0%-93.4%) in group T and 64.7% (33.7%-58.3%) in group no-T, <i>P</i> = .001. Among the 70 patients with TAD/BSA ? 21 mm/m2, patients who received treatment of moderate-or-less TR and those who did not showed similar secondary TR grade at postoperative period (0.5 � 0.6 in group T versus 0.9 � 0.9 in group no-T; <i>P</i> = .2) and follow-up (1.3 � 1.1 in group T versus 1.8 � 1.1 in group no-T; <i>P</i> = .06). In subgroup B (TAD/BSA > 21 mm/m2), patients who received tricuspid valvoplasty manifested more significantly improved outcome than patients without functional TR at postoperative period (0.8 � 0.8 in group T versus 1.6 � 1.3 in group no-T; <i>P</i> = .03) and follow-up (2.0 � 1.2 in group T versus 3.0 � 1.1 in group no-T; <i>P</i> = .005). The multivariate analysis identified TAD/BSA > 21 mm/m2 and preoperative atrial fibrillation (AF) as the risk factors for lower survival at follow-up period.</p><p>Conclusions: Patients with MV surgery have better midterm outcome when they receive either more aggressive and effective surgical treatment for functional TR or moderate-or-less TR preoperatively. Indexed TAD (TAD/BSA > 21 mm/m2) is a more reliable surgical guideline for the treatment of TR. Preoperative tricuspid annulus dilation and AF might be predictors of late lower survival.</p>

scholarly journals Right atrial volume is a major determinant of tricuspid annulus area in functional tricuspid regurgitation: a three-dimensional echocardiographic study

2020 ◽  
Author(s):  
Denisa Muraru ◽  
Karima Addetia ◽  
Andrada C Guta ◽  
Roberto C Ochoa-Jimenez ◽  
Davide Genovese ◽  
...  
Keyword(s):  
Tricuspid Regurgitation ◽  
Multivariable Analysis ◽  
Left Ventricular ◽  
Major Determinant ◽  
Right Atrial ◽  
Left Ventricular Ejection ◽  
Tricuspid Annulus ◽  
Maximal Volume ◽  
Ventricular Ejection Fraction ◽  
Functional Tricuspid Regurgitation

Abstract Aims The aim of this study is to explore the relationships of tricuspid annulus area (TAA) with right atrial maximal volume (RAVmax) and right ventricular end-diastolic volume (RVEDV) in healthy subjects and patients with functional tricuspid regurgitation (FTR) of different aetiologies and severities. Methods and results We enrolled 280 patients (median age 66 years, 59% women) with FTR due to left heart disease (LHD), pulmonary hypertension (PH), corrected tetralogy of Fallot (TOF), chronic atrial fibrillation (AF), and 210 healthy volunteers (45 years, 53% women). We measured TAA at mid-systole and end-diastole, tenting volume of tricuspid leaflets, RAVmax, and RVEDV by 3D echocardiography. Irrespective of TA measurement timing, TAA correlated more closely with RAVmax than with RVEDV in both controls and FTR patients. On multivariable analysis, RAVmax was the most important determinant of TAA, accounting for 41% (normals) and 56% (FTR) of TAA variance. In FTR patients, age, RVEDV, and left ventricular ejection fraction were also independently correlated with TAA. RAVmax (AUC = 0.81) and TAA (AUC = 0.78) had a greater ability than RVEDV (AUC = 0.72) to predict severe FTR (P &lt; 0.05). Among FTR patients, those with AF had the largest RAVmax and smallest RVEDV. RAVmax and TA were significantly dilated in all FTR groups, except in TOF. PH and TOF had largest RVEDV, yet tenting volume was increased only in PH and LHD. Conclusion RA volume is a major determinant of TAA, and RA enlargement is an important mechanism of TA dilation in FTR irrespective of cardiac rhythm and RV loading conditions.

scholarly journals Progression of Tricuspid Regurgitation After Repaired Functional Ischemic Mitral Regurgitation

Circulation ◽  
2005 ◽  
Vol 112 (9_supplement) ◽  
Author(s):  
Akira Matsunaga ◽  
Carlos M. G. Duran
Keyword(s):  
Mitral Valve ◽  
Mitral Regurgitation ◽  
Tricuspid Regurgitation ◽  
De Novo ◽  
Ischemic Mitral Regurgitation ◽  
Tricuspid Annulus ◽  
Valve Repair ◽  
Functional Tricuspid Regurgitation ◽  
Cardiac Lesions

Background— Despite correction of left-sided cardiac lesions, associated functional tricuspid regurgitation (TR) that was surgically ignored can persist. It can also appear de novo. The aim of this study was to analyze TR in a group of patients who underwent successful revascularization and mitral valve repair (MVRep) for functional ischemic mitral regurgitation (MR). Methods and Results— Among 124 consecutive patients with MVRep, 70 left the operating room with MR ≤1+ and had a preoperative and follow-up transthoracic echocardiogra. Moderate or greater MR or TR was considered significant. Twenty-one patients (30%) had TR before surgery, and only 9 had TR repaired. The postoperative incidence of residual TR was not significantly different whether the tricuspid valve had been repaired (4 of 9 [44%]) or surgically ignored (8 of 12 [67%]). At last follow-up, 34 patients (49%) had significant TR. The incidence of TR increased from 25% at <1 year to 53% between 1 and 3 years and 74% at >3 years. Absence or presence of recurrent MR did not significantly affect TR (14 of 22 [64%] with MR versus 20 of 48 [42%] with no MR). Preoperative and postoperative tricuspid annulus size in patients with late TR was significantly larger than in patients without TR. Conclusions— Functional TR is frequently associated with functional ischemic MR. After MVRep, close to 50% of patients have TR. The incidence of postoperative TR increases with time. Preoperative tricuspid annulus dilation might be a predictor of late TR.

Tricuspid Valve Annulus Tension

2011 ◽  
Author(s):  
Shamik Bhattacharya ◽  
Zhaoming He
Keyword(s):  
Right Ventricular ◽  
Tricuspid Valve ◽  
Tricuspid Regurgitation ◽  
Left Ventricular ◽  
Ventricular Dilatation ◽  
Left Ventricular Geometry ◽  
Tricuspid Annulus ◽  
Functional Tricuspid Regurgitation ◽  
Right Ventricular Dilatation ◽  
Annulus Dilatation

Functional tricuspid regurgitation is a direct outcome of right ventricular dilatation and tricuspid annulus dilatation. The mechanism underlying functional tricuspid regurgitation is believed to be multifactorial and related to abnormalities in right ventricular volume, function and shape. Changes in the right ventricle geometry may lead to alterations in the positions of the papillary muscles (PM) of the tricuspid valve (TV). PM displacement happens in right ventricular dilatation but its correlation with tricuspid annulus dilatation is still unknown. The unique structure and orientation of tricuspid PM has role to play in TV annulus mechanics and right ventricular mechanics (Fig.1). It has been already shown that annulus tension (AT) is a parameter to evaluate left ventricular function that, previously, was evaluated via the left ventricular geometry and pressure [1–3].

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