Impact of Tricuspid Annuloplasty on Postoperative Changes in The Right
Ventricular Systolic and Diastolic Function: A Retrospective Cohort
Study
Abstract
Objectives: To elucidate the impact of regulation of tricuspid
regurgitation (TR) using tricuspid annuloplasty on postoperative changes
in right ventricular (RV) systolic and diastolic functions. Methods: We
enrolled 69 patients who underwent aortic or mitral valve surgery
between July 2016 to March 2018 without recurrence. Patients with
concomitant coronary artery bypass grafting or a history of previous
cardiovascular surgery were excluded, remaining 45 patients enrolled.
Patients were divided into 2 groups according to concomitant tricuspid
annuloplasty (T: n=12 vs non-T: n=33). RV global longitudinal strain
(RVGLS), RV fractional area change (RVFAC), tricuspid annular plane
systolic excursion (TAPSE) and early tricuspid inflow velocity/early
diastolic tricuspid annular velocity ratio (tricuspid E/e’) were
assessed as functional indices at preoperative, postoperative and 1-year
follow-up periods. Results: RVFAC deteriorated postoperatively but
recovered at follow-up in group T, whereas that in group non-T showed
gradual deterioration overtime. RVGLS and TAPSE showed similar temporary
deterioration and recovery between groups. Tricuspid E in group T
increased postoperatively and showed significant difference, which was
kept until follow-up period. Tricuspid e’ decreased postoperatively, and
recovered slightly in both groups. As a result, postoperative RV
diastolic function (tricuspid E/e’) showed significant difference
between groups. This difference was maintained until follow-up.
Conclusions: RV systolic function deteriorated postoperatively, but
there was a tendency to improve at follow-up regardless of tricuspid
annuloplasty. RV diastolic function may potentially be impaired when TR
was regulated by tricuspid annuloplasty.