Abstract 2266: Development of Tricuspid Regurgitation Late After Left-Sided Valve Surgery in Patients without Significant Preoperative Tricuspid Regurgitation :A Single-Center Experience with Long-term Echocardiographic Examinations

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Jae-Jin Kwak ◽  
Min-Kyung Kim ◽  
Hyung-Kwan Kim ◽  
Jin-Shik Park ◽  
Kyung-Hwan Kim ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Tricuspid Regurgitation ◽  
Mitral Valve Surgery ◽  
Valve Surgery ◽  
Right Atrial ◽  
Systolic Pulmonary Artery Pressure ◽  
Free Survival ◽  
Single Center Experience

Aim: We investigated the incidence and predictors of tricuspid regurgitation (TR) development long after left-sided valve surgery in patients without significant preoperative TR. Methods: Of 615 patients who underwent surgery for left-sided valve disease between 1992 and 1995, 335 patients without preoperative TR who completed at least 5 years of clinical and echocardiographic follow-up were enrolled. Late significant TR development was assessed by echocardiography with a mean follow-up duration of 11.6 ± 2.1 years. Results: Significant late TR was found in 90 patients (26.9%). Patients with late TR showed; an advanced age, a higher prevalence of atrial fibrillation and prior valve surgery, and a greater left atrial dimension. In addition, late TR was more frequent in patients with mitral valve surgery. Systolic pulmonary artery pressure and mean right atrial pressure were not different between the groups. Multivariate analysis showed that the preoperative atrial fibrillation (OR 5.37; 95% CI. 2.71–10.65; p<0.001) was the only independent factor of late TR development. Patients that developed late TR had a lower event-free survival rate than those that did not (p=0.03). Conclusion: The development of significant TR long after left-sided valve surgery is not uncommon and is associated with a poor prognosis. The preoperative atrial fibrillation is an independent predictor of the late TR. Main Clinical and Echocardiographic Characteristics According to the Presence of Significant Late TR

scholarly journals De Vega annuloplasty versus ring annuloplasty for repair of functional tricuspid regurgitation

2018 ◽  
Vol 6 (2) ◽  
pp. 422
Author(s):  
Khaled Alnawaiseh ◽  
Bashar Albkhoor ◽  
Yanal Alnaser ◽  
Hayel Aladwan ◽  
Issa Ghanma
Keyword(s):  
Mitral Valve ◽  
Tricuspid Valve ◽  
Tricuspid Regurgitation ◽  
Mitral Valve Surgery ◽  
Valve Surgery ◽  
Term Survival ◽  
Free Survival ◽  
Ring Group ◽  
Ring Annuloplasty

Background: Tricuspid insufficiency (TI) is a functional insufficiency in most of the cases and associated with the dilatation of the annulus and remolding. Pulmonary hypertension and right ventricular volume overload due to chronic aortic or / and mitral valve disease in most of the time causes the functional tricuspid insufficiency. Despite the different techniques used to repair the tricuspid valve, the recurrent TR is still occurring in 20- 30 % of the patients and the development of late TR is an important complication of left heart surgery. Our study aims to compare the long-term outcome of ring annuloplasty with De Vega annnuloplasty in patients with secondary tricuspid regurgitation (TR).Methods: A retrospective study of 320 patients who underwent tricuspid valve repair surgery for secondary tricuspid regurgitation from January 2002 to December 2010 at Queen Alia Heart Institute (QAHI). Patients were divided into two groups, in group (1) (n=180) patients had an annuloplasty ring. Group (2) (n=140) patients had De Vega procedure (no ring). The procedures were performed in association with mitral valve surgery in 78% of patients, aortic valve surgery in 15% and combined aortic and mitral valve surgery in 7% of patients. TR grade, NYHA functional class and Pulmonary artery pressure were nearly similar and no significant preoperative difference between the two groups.Results: Echocardiographic and clinical follow up were done for all patients. The duration of procedure for both De Vega and ring annuloplasty were nearly similar. The overall survival in ring group at 5year was 83.9% versus 77.9% in De Vega group. Freedom from residual and recurrent TR, event free survival and long-term survival were significantly better in the ring group and also the tricuspid valve reoperation were less in the ring group.Conclusions: The implantation of annuloplasty ring results in lower incidence of residual or recurrent of tricuspid regurgitation, improved the event-free survival and long-term survival when compared with the sewing techniques such as De Vega.

Long term follow-up in quality of life after mitral valve surgery

2012 ◽  
Vol 60 (S 01) ◽  
Author(s):  
I Kammerer ◽  
M Höhn ◽  
AH Kiessling ◽  
S Becker ◽  
FU Sack
Keyword(s):  
Quality Of Life ◽  
Mitral Valve ◽  
Mitral Valve Surgery ◽  
Valve Surgery ◽  
Long Term Follow Up

P1783Prognostic implications of significant tricuspid regurgitation in patients with atrial fibrillation in the absence of left-sided heart disease or pulmonary hypertension

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
M F Dietz ◽  
E A Prihadi ◽  
P Van Der Bijl ◽  
N Ajmone Marsan ◽  
V Delgado ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Pulmonary Hypertension ◽  
Heart Disease ◽  
Tricuspid Regurgitation ◽  
Left Ventricular ◽  
Right Atrial ◽  
Left Ventricular Ejection ◽  
Event Free Survival ◽  
Free Survival ◽  
Rv Function

Abstract Background Tricuspid regurgitation (TR) can be caused by atrial fibrillation (AF) in the absence of left-sided heart disease or pulmonary hypertension. The prognostic impact of AF-TR has not been investigated. Purpose The aim of this study was to investigate the prognostic significance of TR in AF patients who do not show left-sided heart disease, pulmonary hypertension or primary structural abnormalities. Methods A total of 63 AF patients with moderate and severe TR were identified and matched by age and gender to 116 patients with AF without significant TR, resulting in a total study population of 179 patients (mean age 71±7 years, 59% male). As per design of the study, patients with primary TR, significant (moderate or severe) aortic and/or mitral valve disease, previous valvular surgery, congenital heart disease, left ventricular ejection fraction <50%, systolic pulmonary artery pressure >40mmHg, pacemaker or implantable cardioverter defibrillator leads in situ were excluded as well as patients with AF de novo. Patients were followed for the combined endpoint of all-cause mortality, hospitalization for heart failure and stroke. Results Patients with AF-TR had more often paroxysmal AF as compared to patients without TR (60% vs. 43%, p=0.028). In addition, right atrial volumes and the tricuspid annulus diameter (TAD) were significantly larger in patients with AF-TR compared to their counterparts (p<0.001 for all). Furthermore, tricuspid annular plane systolic excursion was significantly lower in patients with AF-TR (17±5 mm vs. 21±6 mm, p<0.001). During follow-up (median 62 [32–95] months) 55 events for the combined endpoint occurred. One- and 5-year event-free survival rates for patients with TR were 71% and 53%, compared to 92% and 85% for patients without TR, respectively (Log rank Chi-Square p<0.001; Figure). In the multivariable Cox proportional hazard model adjusted for age, gender, NYHA functional class >2, renal function, right ventricular (RV) function and TAD, the presence of significant TR was independently associated with the combined endpoint (HR, 2.495; 95% CI, 1.167–5.335; p=0.018), while RV function was not (HR, 1.026; 95% CI, 0.971–1.085; p=0.364). Figure 1. Kaplan-Meier curves Conclusion In the absence of left-sided heart disease and pulmonary hypertension, significant TR is independently associated with worse event-free survival in patients with AF.

scholarly journals Long-term results and reliability of cryothermic ablation based maze procedure for atrial fibrillation concomitant with mitral valve surgery☆

2009 ◽  
Vol 36 (2) ◽  
pp. 267-271 ◽  
Author(s):  
Toshihiro Funatsu ◽  
Junjiro Kobayashi ◽  
Hiroyuki Nakajima ◽  
Yutaka Iba ◽  
Yusuke Shimahara ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Mitral Valve ◽  
Mitral Valve Surgery ◽  
Valve Surgery ◽  
Maze Procedure ◽  
Long Term Results
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