Late tricuspid regurgitation and right ventricular remodeling after
tricuspid annuloplasty.
Abstract
Background. We sought to determine the relationship between tricuspid
right ventricular (RV) and tricuspid valve (TV) remodeling and late
failure of tricuspid annuloplasty. Methods. From May 2009 to December
2015, 423 patients undergoing tricuspid annuloplasty (TA) for functional
TR at a single were analyzed. Residual TR was defined TR
moderate-or-more at discharge. Recurrent TR was defined
TR-moderate-or-more at follow up. RV remodeling was defined RV
dysfunction and/or dilatation. Results. Residual TR after TA was
recorded in 54. Five-year freedom from TR recurrence was 86.3±2.3% for
patients without residual TR vs 57.6±7.6% for patients with residual
TR, p<0.001. Evaluating late results of 369 patients without
residual TR, following risk factors were identified: preoperative
pulmonary pressure, pre RV remodeling, pre TR and TV remodeling,
functional mitral regurgitation. Conclusions. Prophylactic tricuspid
annuloplasty should be encouraged among surgeons. TA at the time of
left-sided valve surgery should take into consideration not only annular
size, but also tethering severity and RV remodeling.