TY - JOUR
T1 - Tricuspid annuloplasty prevents right ventricular dilatation and progression of tricuspid regurgitation in patients with tricuspid annular dilatation undergoing mitral valve repair
AU - van de Veire, Nico R.
AU - Braun, Jerry
AU - Delgado, Victoria
AU - Versteegh, Michel I. M.
AU - Dion, Robert A.
AU - Klautz, Robert J. M.
AU - Bax, Jeroen J.
N1 - Funding Information: Disclosures: Dr Bax received grants from Biotronik, Medtronic, Boston Scientific Corporation, Bristol–Myers Squibb Medical Imaging, St Jude Medical, GE Healthcare, and Edwards Lifesciences . Dr Dion discloses that he is on the speakers' bureau of Edward Lifesciences. The other authors have nothing to disclose.
PY - 2011/6
Y1 - 2011/6
N2 - Objectives: We hypothesize that concomitant tricuspid annuloplasty in patients with tricuspid annular dilatation who undergo mitral valve repair could prevent progression of tricuspid regurgitation and right ventricular remodeling. Methods: In 2002, 80 patients underwent mitral valve repair. Concomitant tricuspid annuloplasty was performed in 13 patients with grade 3 or 4 tricuspid regurgitation. In 2004, 102 patients underwent mitral valve repair. Concomitant tricuspid annuloplasty was performed in 21 patients with grade 3 or 4 tricuspid regurgitation and in 43 patients with an echocardiographically determined tricuspid annular diameter of 40 mm or greater. Patients underwent transthoracic echocardiographic analysis preoperatively and at the 2-year follow-up. Results: In the 2002 cohort right ventricular dimensions did not decrease (right ventricular long axis, 69 ± 7 vs 70 ± 8 mm; right ventricular short axis, 29 ± 7 vs 30 ± 7 mm); tricuspid regurgitation grade and gradient remained unchanged. In the 2004 cohort right ventricular reverse remodeling was observed (right ventricular long axis, 71 ± 6 vs 69 ± 9 mm; right ventricular short axis, 29 ± 5 vs 27 ± 5 mm; P < .0001); tricuspid regurgitation diminished (1.6 ± 1.0 vs 0.9 ± 0.6, P < .0001), and transtricuspid gradient decreased (28 ± 13 vs 23 ± 15 mm Hg, P = .021). Subanalysis of the 2002 cohort showed that in 23 patients without grade 3 or 4 tricuspid regurgitation but baseline tricuspid annular dilatation, the degree of tricuspid regurgitation was worse at the 2-year follow-up. Moreover, this caused right ventricular dilatation. Subanalysis of the 2004 cohort demonstrated reverse right ventricular remodeling and decreased tricuspid regurgitation in 43 patients with preoperative tricuspid annular dilatation who underwent tricuspid annuloplasty. Conclusions: Concomitant tricuspid annuloplasty during mitral valve repair should be considered in patients with tricuspid annular dilatation despite the absence of important tricuspid regurgitation at baseline because this improves echocardiographic outcome. © 2011 by The American Association for Thoracic Surgery.
AB - Objectives: We hypothesize that concomitant tricuspid annuloplasty in patients with tricuspid annular dilatation who undergo mitral valve repair could prevent progression of tricuspid regurgitation and right ventricular remodeling. Methods: In 2002, 80 patients underwent mitral valve repair. Concomitant tricuspid annuloplasty was performed in 13 patients with grade 3 or 4 tricuspid regurgitation. In 2004, 102 patients underwent mitral valve repair. Concomitant tricuspid annuloplasty was performed in 21 patients with grade 3 or 4 tricuspid regurgitation and in 43 patients with an echocardiographically determined tricuspid annular diameter of 40 mm or greater. Patients underwent transthoracic echocardiographic analysis preoperatively and at the 2-year follow-up. Results: In the 2002 cohort right ventricular dimensions did not decrease (right ventricular long axis, 69 ± 7 vs 70 ± 8 mm; right ventricular short axis, 29 ± 7 vs 30 ± 7 mm); tricuspid regurgitation grade and gradient remained unchanged. In the 2004 cohort right ventricular reverse remodeling was observed (right ventricular long axis, 71 ± 6 vs 69 ± 9 mm; right ventricular short axis, 29 ± 5 vs 27 ± 5 mm; P < .0001); tricuspid regurgitation diminished (1.6 ± 1.0 vs 0.9 ± 0.6, P < .0001), and transtricuspid gradient decreased (28 ± 13 vs 23 ± 15 mm Hg, P = .021). Subanalysis of the 2002 cohort showed that in 23 patients without grade 3 or 4 tricuspid regurgitation but baseline tricuspid annular dilatation, the degree of tricuspid regurgitation was worse at the 2-year follow-up. Moreover, this caused right ventricular dilatation. Subanalysis of the 2004 cohort demonstrated reverse right ventricular remodeling and decreased tricuspid regurgitation in 43 patients with preoperative tricuspid annular dilatation who underwent tricuspid annuloplasty. Conclusions: Concomitant tricuspid annuloplasty during mitral valve repair should be considered in patients with tricuspid annular dilatation despite the absence of important tricuspid regurgitation at baseline because this improves echocardiographic outcome. © 2011 by The American Association for Thoracic Surgery.
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=79956158092&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/20832082
UR - http://www.scopus.com/inward/record.url?scp=79956158092&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.jtcvs.2010.05.050
DO - https://doi.org/10.1016/j.jtcvs.2010.05.050
M3 - Article
C2 - 20832082
SN - 0022-5223
VL - 141
SP - 1431
EP - 1439
JO - Journal of Thoracic and Cardiovascular Surgery
JF - Journal of Thoracic and Cardiovascular Surgery
IS - 6
ER -