Criteria for determining the need for surgical treatment of tricuspid regurgitation during mitral valve replacement

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• 作者：Jigang He (1)
  Zhenya Shen (1)
  Yunsheng Yu (1)
  Haoyue Huang (1)
  Wenxue Ye (1)
  Yinglong Ding (1)
  Shaolei Yang (1)
  
• 关键词：Surgical intervention ; Mitral valve disease ; Tricuspid valve regurgitation ; Criteria
• 刊名：Journal of Cardiothoracic Surgery
• 出版年：2012
• 出版时间：December 2012
• 年：2012
• 卷：7
• 期：1
• 全文大小：316KB
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• 作者单位：Jigang He (1)
  Zhenya Shen (1)
  Yunsheng Yu (1)
  Haoyue Huang (1)
  Wenxue Ye (1)
  Yinglong Ding (1)
  Shaolei Yang (1)
  
  1. Department of Cardiovascular Surgery, First Affiliated Hospital of Soochow University, Suzhou, Jiang Su, 215006, People鈥檚 Republic of China
  

文摘

Background Tricuspid regurgitation (TR) is common in patients with mitral valve disease; however, there are no straightforward, rapidly determinably criteria available for deciding whether TR repair should be performed during mitral valve replacement. The aim of our retrospective study was to identify a simple and fast criterion for determining whether TR repair should be performed in patients undergoing mitral valve replacement. Methods We reviewed the records of patients who underwent mitral valve replacement with or without (control) TR repair (DeVega or Kay procedure) from January 2005 to December 2008. Preoperative and 2-year postoperative echocardiographic measurements included right ventricular and atrial diameter, interventricular septum size, TR severity, ejection fraction, and pulmonary artery pressure. Results A total of 89 patients were included (control, n = 50; DeVega, n = 27; Kay, n = 12). Demographic and clinical characteristics were similar between groups. Cardiac variables were similar between the DeVega and Kay groups. Right atrium and ventricular diameter and ejection fraction were significantly decreased postoperatively both in the control and operation (DeVega + Kay) group (P < 0.05). Pulmonary artery pressure was significantly decreased postoperatively in-operation groups (P < 0.05). Our findings indicate that surgical intervention for TR should be considered during mitral valve replacement if any of the following preoperative criteria are met: right atrial transverse diameter > 57 mm; right ventricular end-diastolic diameter > 55 mm; pulmonary artery pressure > 58 mmHg. Conclusions Our findings suggest echocardiography may be used as a rapid and simple means of determining which patients require TR repair during mitral valve replacement.