Efficiency of different annuloplasty in treating functional tricuspid regurgitation and risk factors for recurrence
Background: Functional tricuspid regurgitation (FTR) is frequent in patients with mitral valve disease. Untreated tricuspid regurgitation (TR) may cause poor clinical outcomes. The surgical factors involved in annuloplasty for FTR remain controversial. Our objective was to compare effectiveness of d...
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| Format: | Article |
| Language: | English |
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Elsevier
2014-12-01
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| Series: | International Journal of Cardiology: Heart & Vasculature |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2352906714000803 |
| _version_ | 1831527677564026880 |
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| author | Yiyun Lin Zhinong Wang Jia He Zhiyun Xu Jian Xiao Yufeng Zhang Hao Peng |
| author_facet | Yiyun Lin Zhinong Wang Jia He Zhiyun Xu Jian Xiao Yufeng Zhang Hao Peng |
| author_sort | Yiyun Lin |
| collection | DOAJ |
| description | Background: Functional tricuspid regurgitation (FTR) is frequent in patients with mitral valve disease. Untreated tricuspid regurgitation (TR) may cause poor clinical outcomes. The surgical factors involved in annuloplasty for FTR remain controversial. Our objective was to compare effectiveness of different tricuspid annuloplasty (TVP), and reveal the risk factors of recurrence.
Methods: We analyzed the clinical details of 399 consecutive patients who underwent mitral surgery with concomitant TVP, from 2006 to 2011, in two Chinese single-centers. Three methods were used for TVP: De Vega surgery was completed in 242 patients; annuloplasty using a flexible band was completed in 98 patients; and surgery with a rigid ring was performed in 59 patients.
Results: The operative mortality rate was 2.3%. After surgery, the TR grade of all patients decreased significantly. At three years postoperatively, 13.7% of patients were diagnosed with recurrent FTR. At the three year time point, severe TR in the De Vega group was 18%, which was higher than those in the flexible (8.4%) and rigid planner ring groups (5.2%). During follow-up, the recurrent rates in the rigid group were significantly lower than in the flexible group. Multivariate analysis revealed that pre-operative atrial fibrillation, severe TR, large left atrial, ejection fraction (EF) < 40%, De Vega annuloplasty, and postoperative permanent pacemaker installation were independent risk factors for severe recurrent TR.
Conclusions: Rigid ring annuloplasty efficaciously improved post-operative tricuspid valve function in patients with FTR. Atrial fibrillation, a large left atrium, low EF and postoperative permanent pacemaker installation were independent risk factors for severe recurrent TR. |
| first_indexed | 2024-12-16T16:33:14Z |
| format | Article |
| id | doaj.art-814a971aa9214f9a9d6c3317096be010 |
| institution | Directory Open Access Journal |
| issn | 2352-9067 |
| language | English |
| last_indexed | 2024-12-16T16:33:14Z |
| publishDate | 2014-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | International Journal of Cardiology: Heart & Vasculature |
| spelling | doaj.art-814a971aa9214f9a9d6c3317096be0102022-12-21T22:24:31ZengElsevierInternational Journal of Cardiology: Heart & Vasculature2352-90672014-12-015C151910.1016/j.ijcha.2014.10.013Efficiency of different annuloplasty in treating functional tricuspid regurgitation and risk factors for recurrenceYiyun Lin0Zhinong Wang1Jia He2Zhiyun Xu3Jian Xiao4Yufeng Zhang5Hao Peng6General Hospital of Beijing Military Command, Nanmencang 5#, Beijing 100700, ChinaChangzheng Hospital, Second Military Medical University, Fengyang Road 415#, Shanghai 200003, ChinaDepartment of Statistics, Second Military Medical University, Xiangyin Road 800#, Shanghai 200433, ChinaChanghai Hospital, Second Military Medical University, Xiangyin Road 800#, Shanghai 200433, ChinaChangzheng Hospital, Second Military Medical University, Fengyang Road 415#, Shanghai 200003, ChinaChangzheng Hospital, Second Military Medical University, Fengyang Road 415#, Shanghai 200003, ChinaChangzheng Hospital, Second Military Medical University, Fengyang Road 415#, Shanghai 200003, ChinaBackground: Functional tricuspid regurgitation (FTR) is frequent in patients with mitral valve disease. Untreated tricuspid regurgitation (TR) may cause poor clinical outcomes. The surgical factors involved in annuloplasty for FTR remain controversial. Our objective was to compare effectiveness of different tricuspid annuloplasty (TVP), and reveal the risk factors of recurrence. Methods: We analyzed the clinical details of 399 consecutive patients who underwent mitral surgery with concomitant TVP, from 2006 to 2011, in two Chinese single-centers. Three methods were used for TVP: De Vega surgery was completed in 242 patients; annuloplasty using a flexible band was completed in 98 patients; and surgery with a rigid ring was performed in 59 patients. Results: The operative mortality rate was 2.3%. After surgery, the TR grade of all patients decreased significantly. At three years postoperatively, 13.7% of patients were diagnosed with recurrent FTR. At the three year time point, severe TR in the De Vega group was 18%, which was higher than those in the flexible (8.4%) and rigid planner ring groups (5.2%). During follow-up, the recurrent rates in the rigid group were significantly lower than in the flexible group. Multivariate analysis revealed that pre-operative atrial fibrillation, severe TR, large left atrial, ejection fraction (EF) < 40%, De Vega annuloplasty, and postoperative permanent pacemaker installation were independent risk factors for severe recurrent TR. Conclusions: Rigid ring annuloplasty efficaciously improved post-operative tricuspid valve function in patients with FTR. Atrial fibrillation, a large left atrium, low EF and postoperative permanent pacemaker installation were independent risk factors for severe recurrent TR.http://www.sciencedirect.com/science/article/pii/S2352906714000803Functional tricuspid regurgitationTricuspid annuloplastyFollow-up |
| spellingShingle | Yiyun Lin Zhinong Wang Jia He Zhiyun Xu Jian Xiao Yufeng Zhang Hao Peng Efficiency of different annuloplasty in treating functional tricuspid regurgitation and risk factors for recurrence International Journal of Cardiology: Heart & Vasculature Functional tricuspid regurgitation Tricuspid annuloplasty Follow-up |
| title | Efficiency of different annuloplasty in treating functional tricuspid regurgitation and risk factors for recurrence |
| title_full | Efficiency of different annuloplasty in treating functional tricuspid regurgitation and risk factors for recurrence |
| title_fullStr | Efficiency of different annuloplasty in treating functional tricuspid regurgitation and risk factors for recurrence |
| title_full_unstemmed | Efficiency of different annuloplasty in treating functional tricuspid regurgitation and risk factors for recurrence |
| title_short | Efficiency of different annuloplasty in treating functional tricuspid regurgitation and risk factors for recurrence |
| title_sort | efficiency of different annuloplasty in treating functional tricuspid regurgitation and risk factors for recurrence |
| topic | Functional tricuspid regurgitation Tricuspid annuloplasty Follow-up |
| url | http://www.sciencedirect.com/science/article/pii/S2352906714000803 |
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