What is the clinical evidence from this study?

Study design: Observational. Population: Functional tricuspid regurgitation (n=216). Intervention: Tricuspid valve annuloplasty. Primary outcome: Residual tricuspid regurgitation (p=<0.001).

February 15, 2005

Tricuspid Valve Tethering Predicts Residual Tricuspid Regurgitation After Tricuspid Annuloplasty

Q: What are the key findings of this study?

Preoperative tricuspid valve tethering distance >0.76 cm predicted residual tricuspid regurgitation after annuloplasty with 86% sensitivity and 80% specificity (P<0.001).

Key Result

Preoperative tricuspid valve tethering distance >0.76 cm predicted residual tricuspid regurgitation after annuloplasty with 86% sensitivity and 80% specificity (P<0.001).

Study Design

Type

Observational (n=216)

PICO

Population

Functional tricuspid regurgitation (n=216)

Intervention / Comparator

Tricuspid valve annuloplasty

Primary Outcome

Residual tricuspid regurgitation, p=<0.001

Main Result

p-value: p=<0.001

Abstract

BACKGROUND: Tricuspid valve (TV) annuloplasty is recommended for functional tricuspid regurgitation (TR), which is caused by TV annulus dilatation and tethering of the leaflets. However, the impact of TV deformations on the outcome of TV annuloplasty remains unknown. The goal of this study was to investigate the relationship between preoperative TV deformation and residual TR after TV annuloplasty. METHODS AND RESULTS: Two hundred sixteen patients with functional TR had 2D echocardiography before and after TV annuloplasty. Right ventricular fractional area change and left ventricular ejection fraction were determined with the apical views. Minimal TV annulus diameter was determined by frame-by-frame analysis. The distance of TV tethering was measured from the annulus plane to the coaptation point and tethering area by tracing the leaflets from the annulus plane. TR severity was determined by the ratio of the maximal jet area to the corresponding right atrial area. The severity of residual TR was associated with age, right and left ventricular dysfunction, tethering distance and area, and severity of preoperative TR (all P0.76 cm and 82% and 84% for tethering areas >1.63 cm2, respectively. CONCLUSIONS: Severe TV tethering predicted residual TR after TV annuloplasty, whereas preoperative TV annular dimension was not associated with outcome of TV annuloplasty.