TY - JOUR
T1 - Tricuspid annulus diameter does not predict the development of tricuspid regurgitation after mitral valve repair for mitral regurgitation due to degenerative diseases
AU - David, Tirone E.
AU - David, Carolyn M.
AU - Manlhiot, Cedric
N1 - Publisher Copyright:
© 2018 The American Association for Thoracic Surgery
PY - 2018/6
Y1 - 2018/6
N2 - Background: Heart valve surgery guidelines suggest that tricuspid valve annuloplasty may be beneficial in patients with a tricuspid annulus (TA) ≥40 mm even in the absence of functional tricuspid regurgitation (TR) at the time of surgery for left-sided valve lesions (class 2a). Given the broad spectrum of degenerative diseases that affect the atrioventricular valves, we hypothesize that this measurement might not be predictive of TR after mitral valve (MV) repair. Methods: The diameter of the TA was measured preoperatively in a cohort of 312 consecutive patients who had isolated MV repair for degenerative diseases. The mean TA diameter was 36 mm (95% confidence interval [CI], 35-37 mm). TA ≥40 mm was present in 80 patients. The median duration of echocardiographic follow-up was 6.7 years (interquartile range, 5.4-8.4 years), and was 100% complete. The main study endpoint was postoperative TR of moderate or greater degree. Results: Thirty patients had new or persistent TR at some point during follow-up. The probability of postoperative TR at 7 years was 6.6% (95% CI, 4.6%-9.4%) for all patients, 6.8% (95% CI, 4.6%-10.4%) for TA <40 mm, and 6.0% (95% CI, 2.9%-12.2%) for TA ≥40 mm. Preoperative TA diameter was not associated with the odds of postoperative TR in either the univariable or multivariable regression models. In these analyses, preoperative TR was the strongest predictor of postoperative TR. Conclusions: TA ≥40 mm is not predictive of the development of postoperative TR after MV repair for degenerative diseases.
AB - Background: Heart valve surgery guidelines suggest that tricuspid valve annuloplasty may be beneficial in patients with a tricuspid annulus (TA) ≥40 mm even in the absence of functional tricuspid regurgitation (TR) at the time of surgery for left-sided valve lesions (class 2a). Given the broad spectrum of degenerative diseases that affect the atrioventricular valves, we hypothesize that this measurement might not be predictive of TR after mitral valve (MV) repair. Methods: The diameter of the TA was measured preoperatively in a cohort of 312 consecutive patients who had isolated MV repair for degenerative diseases. The mean TA diameter was 36 mm (95% confidence interval [CI], 35-37 mm). TA ≥40 mm was present in 80 patients. The median duration of echocardiographic follow-up was 6.7 years (interquartile range, 5.4-8.4 years), and was 100% complete. The main study endpoint was postoperative TR of moderate or greater degree. Results: Thirty patients had new or persistent TR at some point during follow-up. The probability of postoperative TR at 7 years was 6.6% (95% CI, 4.6%-9.4%) for all patients, 6.8% (95% CI, 4.6%-10.4%) for TA <40 mm, and 6.0% (95% CI, 2.9%-12.2%) for TA ≥40 mm. Preoperative TA diameter was not associated with the odds of postoperative TR in either the univariable or multivariable regression models. In these analyses, preoperative TR was the strongest predictor of postoperative TR. Conclusions: TA ≥40 mm is not predictive of the development of postoperative TR after MV repair for degenerative diseases.
KW - tricuspid annulus
KW - tricuspid insufficiency
KW - tricuspid valve
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U2 - 10.1016/j.jtcvs.2017.12.126
DO - 10.1016/j.jtcvs.2017.12.126
M3 - Article
C2 - 29478744
AN - SCOPUS:85044354581
SN - 0022-5223
VL - 155
SP - 2429
EP - 2436
JO - Journal of Thoracic and Cardiovascular Surgery
JF - Journal of Thoracic and Cardiovascular Surgery
IS - 6
ER -