Key result
Higher systolic tricuspid annulus velocity predicts favorable clinical outcomes after surgery for severe TR.
Why the study?
Do specific echocardiographic parameters predict postoperative clinical outcomes in patients undergoing surgery for severe tricuspid regurgitation following prior mitral valve surgery?
Cohort (n=18)
Do specific echocardiographic parameters predict postoperative clinical outcomes in patients undergoing surgery for severe tricuspid regurgitation following prior mitral valve surgery?
Systolic tricuspid annulus velocity (ST') is a useful echocardiographic predictor of favorable postoperative clinical outcomes in patients undergoing surgery for severe tricuspid regurgitation after prior mitral valve surgery.
May support preoperative risk stratification before reoperative tricuspid surgery; leaves open prospective validation before guiding decisions.
Background and Objectives:This study was performed to identify echocardiographic parameters related to postoperative clinical outcome (PCO) in patients undergoing surgery for severe tricuspid regurgitation (TR) following mitral valve surgery. The indications for surgery due to severe TR following mitral valve surgery are not well defined largely because of a lack of knowledge of the prognostic factors of PCO in these patients. Subjects and Methods:Eighteen patients (male/female; 2/16, mean age 58 years) with severe TR associated with prior mitral valve surgery were prospectively enrolled. Comprehensive echocardiographic examinations were performed before and 15±7 months after surgery. Favorable PCO was defined as an improvement of ≥1 in New York Heart Association (NYHA) functional class or a >25% increase in respiratory variation of IVC diameter. Nonsurvivors and survivors without a favorable PCO were defined as having an unfavorable PCO. Results:The operative mortality was 11% (2/18). Of the 16 survivors, nine (9/16, 56%) achieved a favorable PCO. NYHA functional class, age, left ventricular ejection fraction, right ventricular fractional area change, severity of TR and pulmonary artery pressure were not related to PCO. Only systolic tricuspid annulus velocity (ST') was found to be associated with PCO (favorable vs unfavorable PCO; 12.9±2.1cm/s vs 9.7±1.7cm/s, p<0.05). For ST’ value (9.5 cm/s, the sensitivity, specificity, positive and negative predictive values for predicting an unfavorable PCO were 67%, 100%, 100% and 75%, respectively. Conclusion:This study shows that ST’ can predict PCO in patients undergoing surgery for severe TR following mitral valve surgery. (Korean Circulation J 2005;35:916-920)
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Kwon et al. (2005) conducted a cohort in Severe tricuspid regurgitation following mitral valve surgery (n=18). Systolic tricuspid annulus velocity (ST') was evaluated on Favorable postoperative clinical outcome (improvement of ≥1 in NYHA functional class or >25% increase in respiratory variation of IVC diameter) (p=<0.05). Higher systolic tricuspid annulus velocity (ST') predicted favorable postoperative clinical outcomes in patients undergoing surgery for severe tricuspid regurgitation (12.9±2.1 vs 9.7±1.7 cm/s; p<0.05).
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