Published online before print February 14, 2005, doi: 10.1161/01.CIR.0000156449.49998.51
| |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
(Circulation. 2005;111:975-979.)
© 2005 American Heart Association, Inc.
Cardiovascular Surgery |
Tricuspid Valve Tethering Predicts Residual Tricuspid Regurgitation After Tricuspid Annuloplasty
From the Department of Cardiovascular Medicine, Cleveland Clinic Foundation, Cleveland, Ohio.
Reprint requests to Takahiro Shiota, MD, Department of Cardiovascular Medicine, Cleveland Clinic Foundation, 9500 Euclid Ave, Desk F15, Cleveland, OH 44195. E-mail shiotat{at}ccf.org
Received August 19, 2004; revision received November 19, 2004; accepted December 21, 2004.
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 P<0.05). TV annular dimension was not associated with outcome of TV annuloplasty. Multivariate analysis revealed that age, tethering distance, and severity of preoperative TR (all P<0.001) were independent parameters predicting residual TR. The sensitivity and specificity in predicting residual TR after surgery were 86% and 80% for tethering distances >0.76 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.
Key Words: echocardiography • valves • valvoplasty
This article has been cited by other articles:
 |
|
 |
|
  V. Chan, I. G. Burwash, B.-K. Lam, T. Auyeung, A. Tran, T. G. Mesana, and M. Ruel Clinical and echocardiographic impact of functional tricuspid regurgitation repair at the time of mitral valve replacement. Ann. Thorac. Surg., October 1, 2009; 88(4): 1209 - 1215. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 F. Onorati, G. Santarpino, D. Marturano, A. S. Rubino, E. Pasceri, S. Zinzi, G. Mascaro, L. Cristodoro, and A. Renzulli Successful surgical treatment of chronic ischemic mitral regurgitation achieves left ventricular reverse remodeling but does not affect right ventricular function. J. Thorac. Cardiovasc. Surg., August 1, 2009; 138(2): 341 - 351. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. H. Rogers and S. F. Bolling The Tricuspid Valve: Current Perspective and Evolving Management of Tricuspid Regurgitation Circulation, May 26, 2009; 119(20): 2718 - 2725. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. W.C. Scherptong, H. W. Vliegen, M. M. Winter, E. R. Holman, B. J.M. Mulder, E. E. van der Wall, and M. G. Hazekamp Tricuspid Valve Surgery in Adults With a Dysfunctional Systemic Right Ventricle: Repair or Replace? Circulation, March 24, 2009; 119(11): 1467 - 1472. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Shiran and A. Sagie Tricuspid regurgitation in mitral valve disease incidence, prognostic implications, mechanism, and management. J. Am. Coll. Cardiol., February 3, 2009; 53(5): 401 - 408. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. Mutlak, D. Aronson, J. Lessick, S. A. Reisner, S. Dabbah, and Y. Agmon Functional Tricuspid Regurgitation in Patients With Pulmonary Hypertension: Is Pulmonary Artery Pressure the Only Determinant of Regurgitation Severity? Chest, January 1, 2009; 135(1): 115 - 121. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Vahanian, B. Iung, L. Piérard, R. Dion, and J. Pepper CHAPTER 21 Valvular Heart Disease ESC Textbook of Cardiovascular Medicine, January 1, 2009; 2(1): med-9780199566990-chapter - med-9780199566990-chapter. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
2006 WRITING COMMITTEE MEMBERS, R. O. Bonow, B. A. Carabello, K. Chatterjee, A. C. de Leon Jr, D. P. Faxon, M. D. Freed, W. H. Gaasch, B. W. Lytle, R. A. Nishimura, et al. 2008 Focused Update Incorporated Into the ACC/AHA 2006 Guidelines for the Management of Patients With Valvular Heart Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 1998 Guidelines for the Management of Patients With Valvular Heart Disease): Endorsed by the Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons Circulation, October 7, 2008; 118(15): e523 - e661. [Full Text] [PDF]
|
|
|
|
 |
|
 A. Colao, M. Galderisi, A. Di Sarno, M. Pardo, M. Gaccione, M. D'Andrea, E. Guerra, R. Pivonello, G. Lerro, and G. Lombardi Increased Prevalence of Tricuspid Regurgitation in Patients with Prolactinomas Chronically Treated with Cabergoline J. Clin. Endocrinol. Metab., October 1, 2008; 93(10): 3777 - 3784. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. O. Bonow, B. A. Carabello, K. Chatterjee, A. C. de Leon Jr, D. P. Faxon, M. D. Freed, W. H. Gaasch, B. W. Lytle, R. A. Nishimura, P. T. O'Gara, et al. 2008 Focused Update Incorporated Into the ACC/AHA 2006 Guidelines for the Management of Patients With Valvular Heart Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 1998 Guidelines for the Management of Patients With Valvular Heart Disease) Endorsed by the Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons J. Am. Coll. Cardiol., September 23, 2008; 52(13): e1 - e142. [Full Text] [PDF]
|
|
|
|
 |
|
 A. M. Calafiore, A. L. Iaco, M. Contini, and M. Di Mauro A single-size band, 50 mm long, for tricuspid annuloplasty Eur. J. Cardiothorac. Surg., September 1, 2008; 34(3): 677 - 679. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. De Bonis, E. Lapenna, F. Sorrentino, G. La Canna, A. Grimaldi, F. Maisano, L. Torracca, and O. Alfieri Evolution of tricuspid regurgitation after mitral valve repair for functional mitral regurgitation in dilated cardiomyopathy Eur. J. Cardiothorac. Surg., April 1, 2008; 33(4): 600 - 606. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Enriquez-Sarano, V. T. Nkomo, and H. Michelena Principles and Practice of Echocardiography in Cardiac Surgery Card. Surg. Adult, January 1, 2008; 3(2008): 315 - 348. [Full Text]
|
|
|
|
|
|
R. K. Ghanta, R. Chen, N. Narayanasamy, S. McGurk, S. Lipsitz, F. Y. Chen, and L. H. Cohn Suture bicuspidization of the tricuspid valve versus ring annuloplasty for repair of functional tricuspid regurgitation: Midterm results of 237 consecutive patients J. Thorac. Cardiovasc. Surg., January 1, 2007; 133(1): 117 - 126. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. O. Bonow, B. A. Carabello, K. Chatterjee, A. C. de Leon Jr, D. P. Faxon, M. D. Freed, W. H. Gaasch, B. W. Lytle, R. A. Nishimura, P. T. O'Gara, et al. ACC/AHA 2006 Guidelines for the Management of Patients With Valvular Heart Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 1998 Guidelines for the Management of Patients With Valvular Heart Disease) Developed in Collaboration With the Society of Cardiovascular Anesthesiologists Endorsed by the Society for Cardiovascular Angiography and Interventions and the Society of Thoracic Surgeons J. Am. Coll. Cardiol., August 1, 2006; 48(3): e1 - e148. [Full Text] [PDF]
|
|
|
|
|
|
R. O. Bonow, B. A. Carabello, K. Chatterjee, A. C. de Leon Jr, D. P. Faxon, M. D. Freed, W. H. Gaasch, B. W. Lytle, R. A. Nishimura, P. T. O'Gara, et al. ACC/AHA 2006 Practice Guidelines for the Management of Patients With Valvular Heart Disease: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 1998 Guidelines for the Management of Patients With Valvular Heart Disease) Developed in Collaboration With the Society of Cardiovascular Anesthesiologists Endorsed by the Society for Cardiovascular Angiography and Interventions and the Society of Thoracic Surgeons J. Am. Coll. Cardiol., August 1, 2006; 48(3): 598 - 675. [Full Text] [PDF]
|
|
|
|
|
|
T.-T. Ton-Nu, R. A. Levine, M. D. Handschumacher, D. J. Dorer, C. Yosefy, D. Fan, L. Hua, L. Jiang, and J. Hung Geometric Determinants of Functional Tricuspid Regurgitation: Insights From 3-Dimensional Echocardiography Circulation, July 11, 2006; 114(2): 143 - 149. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Fukuda, G. Saracino, Y. Matsumura, M. Daimon, H. Tran, N. L. Greenberg, T. Hozumi, J. Yoshikawa, J. D. Thomas, and T. Shiota Three-Dimensional Geometry of the Tricuspid Annulus in Healthy Subjects and in Patients With Functional Tricuspid Regurgitation: A Real-Time, 3-Dimensional Echocardiographic Study Circulation, July 4, 2006; 114(1_suppl): I-492 - I-498. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Fukuda, A. M. Gillinov, P. M. McCarthy, W. J. Stewart, J.-M. Song, T. Kihara, M. Daimon, M.-S. Shin, J. D. Thomas, and T. Shiota Determinants of Recurrent or Residual Functional Tricuspid Regurgitation After Tricuspid Annuloplasty Circulation, July 4, 2006; 114(1_suppl): I-582 - I-587. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. H. Rahimtoola The Year in Valvular Heart Disease J. Am. Coll. Cardiol., January 17, 2006; 47(2): 427 - 439. [Full Text] [PDF]
|
|