Prognosis Factors of Tricuspid Regurgitation after the Operation for Left-sided Valvular Heart Disease.
- Author:
Ung JIN
1
;
Hwan Wook KIM
;
Jong Ho LEE
;
Jong Bum KWEON
;
Min Seop JO
;
Jeong Seob YOON
;
Seok Whan MOON
;
Sung Bo SIM
;
Kuhn PARK
;
Chi Kyung KIM
;
Keon Hyun CHO
;
Young Pil WANG
;
Sun He LEE
;
Moon Sub KWACK
Author Information
1. Department of Thoracic and Cardiovascular Surgery, Catholic University Medical College, Korea. ckkim@sph.cuk.ac.kr
- Publication Type:Original Article
- Keywords:
Tricuspid valve insufficiency;
Heart valve disease
- MeSH:
Follow-Up Studies;
Heart Failure;
Heart Valve Diseases*;
Humans;
Medical Records;
Prognosis*;
Pulmonary Artery;
Stroke Volume;
Tricuspid Valve Insufficiency*
- From:The Korean Journal of Thoracic and Cardiovascular Surgery
2003;36(3):150-156
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: Tricuspid regurgitation has been considered as a secondary lesion when it is combined with left valvular heart diseases. However, there have been some reports which show that tricuspid regurgitation keeps going and results in congestive heart failure even after a successful operation for left valvular heart disease. So far, there are no definite operation indications and predictive factors for the tricuspid regurgitation which is resulted from the left sided valvular heart disease. We designed this study to evaluate the effects of pulmonary artery pressure and left ventricular ejection fraction on the prognosis of tricuspid regurgitation, and to make an operation indication for the patients with secondary tricuspid regurgitation. MATERIAL AND METHOD: We reviewed the medical records of patients who underwent surgery for the left sided valvular heart disease with tricuspid regurgitation and were followed for more than 1 year with echocardiograms. There was a total of 114 cases. We compared the grades of tricuspid regurgitations and pulmonary artery pressures and left ventricular ejection fractions on the basis of echocardiograms which were checked preoperatively and on the last follow up. RESULT: There were 43 cases of tricuspid annuloplasty. In these patients, the grades of tricuspid regurgitations were improved in 42 cases (97.7%). But in 71 cases without annuloplasty, 29 cases (41%) were improved, 32 cases (45%) had no change, and 10 cases (14%) were aggravated. This finding shows significant differences in the prognoses of tricuspid regurgitations between the two groups (p<0.05). There was no difference in pulmonary artery pressures and ejection fractions between the patients who showed progression of tricuspid regurgitations and those who didn't (p>0.05). The improvements of tricuspid regurgitations are not statistically related to the changes of pulmonary artery pressures or left ventricular ejection fractions. CONCLUSION: This study shows that it is impossible to predict the prognoses of tricuspid regurgitations with preoperative pulmonary artery pressures or left ventricular ejection fractions. Also, the excellent results of tricuspid annuloplasty is proven in controlling the secondary tricuspid regurgitations. Therefore, when tricuspid regurgitation is detected preoperatively, the procedures to correct the tricuspid regurgitation at the time of the operation for the left-sided valvular heart disease must be considered positively, regardless of the grades of tricuspid regurgitations, to prevent significant tricuspid regurgitation that may develop later.
