| Geometric changes after tricuspid annuloplasty and predictors of residual tricuspid regurgitation: a real-time three-dimensional echocardiography study. | |
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MedLine Citation:
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PMID: 20601392 Owner: NLM Status: In-Process |
Abstract/OtherAbstract:
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AIMS: We sought to demonstrate geometric changes in the tricuspid valve (TV) apparatus after tricuspid annuloplasty (TAP) and to identify predictors of residual tricuspid regurgitation (TR) in patients with functional TR using real-time three-dimensional echocardiography (RT3DE). METHODS AND RESULTS: RT3DE and two-dimensional colour Doppler echocardiography were performed in 59 consecutive patients before and 4.7 ± 2.1 days after TAP. The tenting angles of the three leaflets were significantly increased, whereas tenting volume, annulus diameters, and septal-lateral right ventricular inlet dimension decreased after TAP. By multiple stepwise linear regression analysis, tenting volume (P < 0.001) and antero-posterior annulus diameter (P = 0.043) before TAP were major predictors of residual TR assessed using distal jet area. When TR severity was quantified by vena contracta width, tenting volume (P < 0.001) before TAP was the only independent predictor. Pre-TAP tenting volume ≥1.68 mL (sensitivity of 86%, specificity of 73%), and ≥2.30 mL (sensitivity of 100%, specificity of 84%) were the best cut-off values predicting severe residual TR quantified using distal jet area and vena contracta width, respectively. After TAP, tenting volume and pulmonary artery systolic pressure were major determinants of residual TR. CONCLUSION: Tenting angles of all three leaflets increase, whereas annulus diameters decrease, after TAP. Pre-TAP tenting volume and antero-posterior annulus diameter measured using RT3DE are independent predictors of residual TR severity, and measurement of these parameters may help to identify patients at high risk for severe residual TR, for whom TV replacement should possibly be initially considered. |
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Authors:
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Sun-Yang Min; Jong-Min Song; Jeong-Hoon Kim; Min-Kyong Jang; Yun-Jeong Kim; Haeguen Song; Dae-Hee Kim; Jae Won Lee; Duk-Hyun Kang; Jae-Kwan Song |
Publication Detail:
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Type: Journal Article Date: 2010-07-02 |
Journal Detail:
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Title: European heart journal Volume: 31 ISSN: 1522-9645 ISO Abbreviation: Eur. Heart J. Publication Date: 2010 Dec |
Date Detail:
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Created Date: 2010-12-02 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8006263 Medline TA: Eur Heart J Country: England |
Other Details:
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Languages: eng Pagination: 2871-80 Citation Subset: IM |
Affiliation:
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Division of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, 388-1 Poongnap2-dong, Songpa-gu,Seoul 138-736, South Korea. |
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Comment In:
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Eur Heart J. 2010 Dec;31(23):2841-3
[PMID:
20729224
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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