Document Detail

Improvement of tricuspid regurgitation after pulmonary thromboendarterectomy.
MedLine Citation:
PMID:  11899178     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: For patients with chronic thromboembolic pulmonary hypertension who undergo pulmonary thromboendarterectomy (PTE) it has not yet been systematically investigated how operation affects the severity of tricuspid regurgitation (TR). This study sought (1) to evaluate the extent of TR reversibility after operation, (2) to identify potential predictors of the reversibility of TR, and (3) to investigate the influence of geometric and hemodynamic alterations on the extent of TR severity. METHODS: Thirty-nine patients (55+/-12 years) undergoing PTE without tricuspid valve repair were investigated before and 13+/-8 days after operation by Doppler color flow mapping. Geometry of the tricuspid valve as well as right ventricular size and function were determined with echocardiography. Mean pulmonary arterial pressure was determined invasively. RESULTS: After PTE, mean pulmonary arterial pressure was significantly lower (48+/-10 versus 25+/-7 mm Hg, p < 0.05). Most of the patients had a distinct reduction of TR, and the improvement trend showed on the severity scale: number of patients with 4+TR (23 --> 4), 3+TR (12 --> 12), 2+TR (2 --> 13), and 1+TR (2 --> 10). Examination after PTE revealed profound reduction of right ventricular size and annulus diameter, with a normalization of the valvular geometry. However, none of the study variables were useful as indicators of the postoperative outcome. CONCLUSIONS: After PTE without additional valve repair most patients show significantly reduced severity of TR soon afterward; the very few cases in which TR does not improve remain unidentifiable before operation. Our recommendation is consequently to refrain from additional tricuspid repair in patients undergoing PTE.
Thomas Menzel; Thorsten Kramm; Stephan Wagner; Susanne Mohr-Kahaly; Eckhard Mayer; Juergen Meyer
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  73     ISSN:  0003-4975     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  2002 Mar 
Date Detail:
Created Date:  2002-03-18     Completed Date:  2002-03-29     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  756-61     Citation Subset:  AIM; IM    
Department of Cardiology, Johannes Gutenberg-University, Mainz, Germany.
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MeSH Terms
Echocardiography, Doppler, Color
Hypertension, Pulmonary / complications,  surgery*
Middle Aged
Pulmonary Artery / surgery*
Tricuspid Valve Insufficiency / etiology*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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