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Factors associated with development of late significant tricuspid regurgitation after successful left-sided valve surgery
- Source :
- Heart. 95:931-936
- Publication Year :
- 2009
- Publisher :
- BMJ, 2009.
-
Abstract
- Persistent significant tricuspid regurgitation (TR) after successful left-sided valve surgery is frequently reported.To evaluate the incidence, risk factors and clinical impact of development of late significant TR after successful left-sided valve surgery.638 patients (356 men, mean age 52 (SD 14) years) who had mild (or=grade 2/4) TR and underwent successful surgery without any procedure for TR were analysed. Development of significant TR was defined as a TR increase by more than one grade and final TR gradeor=3/4 at follow-up echocardiography. Clinical events were defined as cardiovascular death, repeated open-heart surgery, and congestive heart failure requiring hospital admission. The overall incidence of late significant TR was 7.7% (49/638). Age (hazard ratio (HR), 1.0, 95% CI, 1.0 to 1.1; p = 0.005), female gender (HR, 5.0; 95% CI 2.0 to 12.7; p = 0.001), rheumatic aetiology (HR, 3.8; 95% CI 1.4 to 10.3; p = 0.011), atrial fibrillation (Af) (HR, 2.6; 95% CI 1.1 to 6.4; p = 0.035) and peak pressure gradient of TR at follow-up (HR, 1.1; 95% CI 1.0 to 1.1; p0.001) were independent factors associated with development of late significant TR. During clinical follow-up of 101 (24) months, patients who developed late significant TR showed a significantly lower 8-year clinical event-free survival rate (76 (6) vs 91 (1)%, p0.001).Several clinical variables were independent risk factors for development of late significant TR. Early surgical intervention for TR in selected patients with these risk factors may be justified, even though they have only mild TR.
- Subjects :
- Adult
Male
Aortic valve
medicine.medical_specialty
Heart Valve Diseases
Postoperative Complications
Sex Factors
Internal medicine
Mitral valve
medicine
Humans
Postoperative Period
Heart valve
Aged
Ultrasonography
Tricuspid valve
business.industry
Hazard ratio
valvular heart disease
Age Factors
Atrial fibrillation
Middle Aged
medicine.disease
Tricuspid Valve Insufficiency
Surgery
medicine.anatomical_structure
Aortic Valve
Heart failure
Disease Progression
Cardiology
Mitral Valve
Female
Epidemiologic Methods
Cardiology and Cardiovascular Medicine
business
Subjects
Details
- ISSN :
- 13556037
- Volume :
- 95
- Database :
- OpenAIRE
- Journal :
- Heart
- Accession number :
- edsair.doi.dedup.....0f71823d230fae83a864548869563f20