OBJECTIVES: Functional tricuspid regurgitation (FTR) worsens over time, and its natural history is unfavorable. An aggressive surgical strategy, using the echocardiographic systolic dimensions of the tricuspid annulus (sysTA), can be helpful to reduce the detrimental late effects of FTR. METHODS: From March 2006 to February 2008, 298 patients, with at least FTR grade 1+, underwent mitral valve surgery. Of these 298 patients, 167 underwent tricuspid repair (treated group [T], moderate-or-greater FTR in 108 and mild in 59, with sysTA > 24 mm) and 137 did not (untreated group [UT], moderate-or-greater FTR in 16 and mild in 115; 81 with sysTA > 24 mm and 34 with sysTA of ≤ 24 mm). The 256 survivors underwent echocardiographic examination at a mean follow-up of 13 ± 8 months. RESULTS: Preoperatively, at discharge, and at the follow-up examination, the mean FTR grade was 1.11 ± 0.32, 0.87 ± 0.49, and 1.03 ± 0.57 (P = NS) in the UT group and 2.11 ± 0.92, 0.45 ± 0.36, and 0.48 ± 0.32 (P < .001) in the T group. A total of 24 patients had FTR grade 2 or greater, 16 (14.5%) in the UT group and 8 (5.5%) in the T group (P = .026). In the UT group, 10 of 16 patients had sysTA of 25 to 28 mm and 6 of 10 had sysTA greater than 28 mm. No patient with mild FTR and sysTA of 24 mm or less had an increased FTR grade. Globally, 12 patients (10.9%) had an increased FTR grade in the UT group versus none in the T group (P < .001). Patients with postoperative atrial fibrillation had less residual FTR if annuloplasty had been performed (1.6 ± 0.7 vs 0.91 ± 0.63, P = .005). CONCLUSIONS: An aggressive strategy for FTR correction, using the sysTA, was able to reduce the FTR grade 1 year after surgery, but mitral surgery alone could not.
OBJECTIVES: Functional tricuspid regurgitation (FTR) worsens over time, and its natural history is unfavorable. An aggressive surgical strategy, using the echocardiographic systolic dimensions of the tricuspid annulus (sysTA), can be helpful to reduce the detrimental late effects of FTR. METHODS: From March 2006 to February 2008, 298 patients, with at least FTR grade 1+, underwent mitral valve surgery. Of these 298 patients, 167 underwent tricuspid repair (treated group [T], moderate-or-greater FTR in 108 and mild in 59, with sysTA > 24 mm) and 137 did not (untreated group [UT], moderate-or-greater FTR in 16 and mild in 115; 81 with sysTA > 24 mm and 34 with sysTA of ≤ 24 mm). The 256 survivors underwent echocardiographic examination at a mean follow-up of 13 ± 8 months. RESULTS: Preoperatively, at discharge, and at the follow-up examination, the mean FTR grade was 1.11 ± 0.32, 0.87 ± 0.49, and 1.03 ± 0.57 (P = NS) in the UT group and 2.11 ± 0.92, 0.45 ± 0.36, and 0.48 ± 0.32 (P < .001) in the T group. A total of 24 patients had FTR grade 2 or greater, 16 (14.5%) in the UT group and 8 (5.5%) in the T group (P = .026). In the UT group, 10 of 16 patients had sysTA of 25 to 28 mm and 6 of 10 had sysTA greater than 28 mm. No patient with mild FTR and sysTA of 24 mm or less had an increased FTR grade. Globally, 12 patients (10.9%) had an increased FTR grade in the UT group versus none in the T group (P < .001). Patients with postoperative atrial fibrillation had less residual FTR if annuloplasty had been performed (1.6 ± 0.7 vs 0.91 ± 0.63, P = .005). CONCLUSIONS: An aggressive strategy for FTR correction, using the sysTA, was able to reduce the FTR grade 1 year after surgery, but mitral surgery alone could not.
Authors: James S Gammie; Michael W A Chu; Volkmar Falk; Jessica R Overbey; Alan J Moskowitz; Marc Gillinov; Michael J Mack; Pierre Voisine; Markus Krane; Babatunde Yerokun; Michael E Bowdish; Lenard Conradi; Steven F Bolling; Marissa A Miller; Wendy C Taddei-Peters; Neal O Jeffries; Michael K Parides; Richard Weisel; Mariell Jessup; Eric A Rose; John C Mullen; Samantha Raymond; Ellen G Moquete; Karen O'Sullivan; Mary E Marks; Alexander Iribarne; Friedhelm Beyersdorf; Michael A Borger; Arnar Geirsson; Emilia Bagiella; Judy Hung; Annetine C Gelijns; Patrick T O'Gara; Gorav Ailawadi Journal: N Engl J Med Date: 2021-11-13 Impact factor: 91.245
Authors: Massimiliano Foschi; Michele Di Mauro; Fabrizio Tancredi; Carlo Capparuccia; Renata Petroni; Luigi Leonzio; Silvio Romano; Sabina Gallina; Maria Penco; Mario Cibelli; Antonio Calafiore Journal: J Cardiovasc Dev Dis Date: 2017-10-20
Authors: R Jansen; B R van Klarenbosch; M J Cramer; R C A Meijer; P H M Westendorp; H W J Meijburg; J J J Bucx; S A J Chamuleau; J Kluin Journal: Neth Heart J Date: 2018-11 Impact factor: 2.380