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Tricuspid regurgitation severity after atrial septal defect closure or pulmonic valve replacement.
- Source :
- Heart; Mar2020, Vol. 106 Issue 6, p455-461, 7p
- Publication Year :
- 2020
-
Abstract
- <bold>Objectives: </bold>Cardiac surgery or catheter interventions are nowadays commonly performed to reduce volume loading of the right ventricle in adults with congenital heart disease. However, little is known, on the effect of such procedures on pre-existing tricuspid regurgitation (TR). We assessed the potential reduction in the severity of TR after atrial septal defect (ASD) closure and pulmonic valve replacement (PVR).<bold>Methods: </bold>Demographics, clinical and echocardiographic characteristics of consecutive patients undergoing ASD closure or PVR between 2005 and 2014 at a single centre who had at least mild preoperative TR were collected and analysed.<bold>Results: </bold>Overall, 162 patients (mean age at intervention 41.6±16.1 years, 38.3% male) were included: 101 after ASD closure (61 transcatheter vs 40 surgical) and 61 after PVR (3 transcatheter vs 58 surgical). Only 11.1% received concomitant tricuspid valve surgery (repair). There was significant reduction in the severity of TR in the overall population, from 38 (23.5%) patients having moderate or severe TR preoperatively to only 11 (6.8%) and 20 (12.3%) at 6 months and 12 months of follow-up, respectively (McNemar p<0.0001). There was a significant reduction in tricuspid valve annular diameter (p<0.0001), coaptation distance (p<0.0001) and systolic tenting area (p<0.0001). The reduction in TR was also observed in patients who did not have concomitant tricuspid valve (TV) repair (from 15.3% to 6.9% and 11.8% at 6 and 12 months, respectively, p<0.0001). On multivariable logistic regression including all univariable predictors of residual TR at 12 months, only RA area remained in the model (OR 1.2, 95% CI 1.04 to 1.37, p=0.01).<bold>Conclusions: </bold>ASD closure and PVR are associated with a significant reduction in tricuspid regurgitation, even among patients who do not undergo concomitant tricuspid valve surgery. [ABSTRACT FROM AUTHOR]
- Subjects :
- ATRIAL septal defects
TRICUSPID valve surgery
CONGENITAL heart disease
TRICUSPID valve
TRICUSPID valve diseases
VALVES
PULMONARY valve
HEART valve diseases
CARDIAC surgery
RESEARCH
RESEARCH methodology
RETROSPECTIVE studies
EVALUATION research
MEDICAL cooperation
SEVERITY of illness index
COMPARATIVE studies
PROSTHETIC heart valves
RESEARCH funding
DISEASE complications
Subjects
Details
- Language :
- English
- ISSN :
- 13556037
- Volume :
- 106
- Issue :
- 6
- Database :
- Complementary Index
- Journal :
- Heart
- Publication Type :
- Academic Journal
- Accession number :
- 141951572
- Full Text :
- https://doi.org/10.1136/heartjnl-2019-315287