Mid-term functional recovery after tricuspid annuloplasty concomitant with left-sided valve surgery
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ORIGINAL ARTICLE
Mid‑term functional recovery after tricuspid annuloplasty concomitant with left‑sided valve surgery Tomoki Sakata1,2 · Kenji Mogi1 · Kaoru Matsuura2 · Manabu Sakurai1 · Yuki Shiko3 · Yohei Kawasaki3 · Goro Matsumiya2 · Yoshiharu Takahara1 Received: 23 April 2020 / Accepted: 21 September 2020 © The Japanese Association for Thoracic Surgery 2020
Abstract Background To elucidate the impact of tricuspid annuloplasty concomitant with left-sided valve surgery on the right ventricular (RV) function in patients with mild or more tricuspid regurgitation (TR). Methods We enrolled 136 patients with mild or more TR who underwent left-sided valve surgery. Seventy-three patients underwent left-sided valve surgery alone (group non-T) and 63 underwent concomitant tricuspid annuloplasty (group T). The echocardiographic data at the latest follow-up (mean 1019 days) were compared using multiple regression analysis to adjust cofounding factors. Propensity score was calculated and included in the analysis as a covariate. In addition, propensity score matching was used for sensitive analysis (12 pairs). Results In group non-T, there were more aortic valve surgeries, and fewer mitral valve surgeries. At baseline, body surface area, New York Heart Association class, and prevalence of atrial fibrillation were significantly different between groups. On preoperative echocardiography, left and right atrial diameter, RV diameter, and tricuspid annular diameter were larger in group T, whereas there was no significant difference in RV fractional area change. In multiple regression analyses, RV diameter in diastole was significantly lower and RV fractional area change was significantly higher at the follow-up period in group T. These results were not attenuated even in subgroup analysis in patients with only mild TR or mitral valve surgery alone. Conclusion Among patients with mild or more TR, RV dimensional and functional recovery was not obtained with left-sided valve surgery alone. Adding tricuspid annuloplasty may potentially achieve both outcomes. Keywords Tricuspid regurgitation · Tricuspid annuloplasty · Right ventricular function
Introduction This paper was presented at the 72nd annual scientific meeting of the Japanese Association for Thoracic Surgery, Kyoto, Japan (October 30–November 2, 2019). Electronic supplementary material The online version of this article (https://doi.org/10.1007/s11748-020-01501-4) contains supplementary material, which is available to authorized users. * Tomoki Sakata [email protected] 1
Division of Cardiovascular Surgery, Heart and Vascular Institute, Funabashi Municipal Medical Center, 1‑21‑1 Kanasugi, Chiba, Funabashi 273‑8588, Japan
2
Department of Cardiovascular Surgery, Chiba University Hospital, Chiba, Japan
3
Biostatistics Section, Clinical Research Center, Chiba University Hospital, Chiba, Japan
Tricuspid annuloplasty concomitant with left-sided valve surgery is a gold standard therapy to control functional tricuspid regurgitation (TR) and has shown favora
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