Dong Seop Jeong, Man-shik Shim, Kiick Sung, Wook Sung Kim, Young Tak Lee, Pyo Won Park
Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
Background and aim of the study: The study aim was to evaluate the effect of prophylactic tricuspid annuloplasty (TAP) on late tricuspid regurgitation (TR) after double valve (aortic and mitral) replacement (DVR).
Methods: Among 239 patients undergoing DVR at the authors’ institution between 1994 and 2009, a total of 93 patients who had a less than moderate degree of preoperative TR was analyzed. Concomitant TAP was performed in 55 patients (TAP group). The mean follow up duration was 7.3 ± 4.1 years (maximum 15.9 years). Serial echocardiographic data at one, three, five and more than seven years were analyzed.
Results: There was no early mortality, but eight late cardiac-related mortalities occurred (8.6%). In the aortic position, the transprosthetic mean pressure gradient (TMPG) was increased during follow up (13.5 ± 5.3 mmHg
versus 16.4 ± 10.2 mmHg, p = 0.006). However, the mitral TMPG did not change significantly (3.7 ± 1.4 mmHg versus 3.8 ± 1.6 mmHg, p = 0.677). Freedom from valve-related events at 10 years was higher in the TAP group than in the non-TAP group (85.2 ± 5.9% versus 63.3 ± 0.9%; p = 0.05). Freedom from more than moderate TR at 10 years was also higher in the TAP group (93.6 ± 4.7% versus 66.3 ± 10.3%; p = 0.03). The transmitral pressure gradient was associated with valve-related events (p = 0.025; HR, 1.367). An absence of TAP was predictive of late TR (p = 0.020; HR, 4.4).
Conclusion: The study results suggested that TAP can be considered in patients who require DVR, even if the TR grade is less than moderate, in order to prevent the late occurrence of TR.
The Journal of Heart Valve Disease 2015;24:508-515
|Prophylactic Tricuspid Annuloplasty in Patients Undergoing Double Valve Replacement|
Click the above hyperlink to view the article, right click (Ctrl click on a Mac) to open in a new browser window or tab.
Please click the button below to purchase this article. Single article purchases are provided at $50.00 per article. Upon clicking the button below, single article user account subscription details are requested and, upon successful payment, a single article user account is created. Single articles are availble in your account for seven days after purchase.