| Development of tricuspid regurgitation late after left-sided valve surgery: a single-center experience with long-term echocardiographic examinations. | |
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MedLine Citation:
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PMID: 18371484 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: This study sought to investigate the incidence and identify the predictors of significant tricuspid regurgitation (TR) development long after left-sided valve surgery. METHODS: Of 615 patients who underwent surgery for left-sided valve disease between 1992 and 1995, 335 patients without significant TR who completed at least 5 years of clinical and echocardiographic follow-up were enrolled. Late significant TR development was assessed by echocardiography with a mean follow-up duration of 11.6 +/- 2.1 years. RESULTS: Significant late TR was found in 90 patients (26.9%). Patients with late TR showed an advanced age (47.6 +/- 13.4 vs 44.3 +/- 13.2 years, P = .04), a higher prevalence of preoperative atrial fibrillation (83.3 vs 46.5%, P < .001), a greater left atrial dimension (56.9 +/- 13.2 vs 52.4 +/- 11.5 mm, P = .006), and a higher prevalence of prior valve surgery (40.0 vs 25.3%, P = .01). In addition, late TR occurred more frequently in patients who had undergone mitral valve surgery than in those who did not (93.3 vs 72.2%, P < .001). However, multivariate analysis showed that the presence of preoperative atrial fibrillation (odds ratio 5.37; 95% CI 2.71-10.65; P < .001) was the only independent factor of late TR development. Patients who developed late TR had a lower event-free survival rate than those who did not (P = .03). CONCLUSIONS: The development of significant TR long after left-sided valve surgery is not uncommon with an estimated incidence of 27% and is closely associated with a poor prognosis. The presence of preoperative atrial fibrillation was identified as the only independent predictor of the development of late TR. |
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Authors:
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Jae-Jin Kwak; Yong-Jin Kim; Min-Kyung Kim; Hyung-Kwan Kim; Jin-Shik Park; Kyung-Hwan Kim; Ki-Bong Kim; Hyuk Ahn; Dae-Won Sohn; Byung-Hee Oh; Young-Bae Park |
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Publication Detail:
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Type: Journal Article Date: 2008-02-21 |
Journal Detail:
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Title: American heart journal Volume: 155 ISSN: 1097-6744 ISO Abbreviation: Am. Heart J. Publication Date: 2008 Apr |
Date Detail:
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Created Date: 2008-03-28 Completed Date: 2008-04-18 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0370465 Medline TA: Am Heart J Country: United States |
Other Details:
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Languages: eng Pagination: 732-7 Citation Subset: AIM; IM |
Affiliation:
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Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea. |
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Aged Aged, 80 and over Aortic Valve / surgery Atrial Fibrillation / complications Disease-Free Survival Echocardiography Female Follow-Up Studies Heart Valve Diseases / surgery* Humans Incidence Logistic Models Male Middle Aged Mitral Valve / surgery Multivariate Analysis Postoperative Complications* / epidemiology Preoperative Care Risk Factors Stroke Volume Time Factors Tricuspid Valve Insufficiency / epidemiology, etiology* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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