Document Detail


Long-term evaluation of treatment for functional tricuspid regurgitation with regurgitant volume: characteristic differences based on primary cardiac lesion.
MedLine Citation:
PMID:  10047648     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: The aim of this study was to characterize differences in the long-term effects of treatment for functional tricuspid regurgitation based on the primary cardiac lesion. METHODS: Ninety-six patients with valvular heart disease and 32 patients with atrial septal defects associated with tricuspid regurgitation were studied. The tricuspid annular diameter was associated with evidence of right heart failure. In valvular heart disease, a Kay annuloplasty was performed in 33 patients with a tricuspid annular diameter of >/=40 mm to 44 mm, a modified De Vega annuloplasty in 12 patients with a tricuspid annular diameter of >/=45 mm to 49 mm, and a modified De Vega annuloplasty, annuloplasty using a Carpentier ring, or tricuspid valve replacement in each of 4 patients with a tricuspid annular diameter of >/=50 mm. In atrial septal defects, a Kay annuloplasty was performed in 11 patients with a tricuspid annular diameter of >/=45 mm to 49 mm, and a modified De Vega annuloplasty was performed in 5 patients with a tricuspid annular diameter of >/=50 mm. A mean follow-up period was 79 months after operation. RESULTS: In the patients with a tricuspid annular diameter of <50 mm, the hemodynamic and clinical findings and tricuspid regurgitation remarkably improved. In the patients with valvular heart disease with a tricuspid annular diameter of >/=50 mm, however, the right heart parameters also showed improvement but less so when compared with those patients with a tricuspid annular diameter of <50 mm. In addition, 4 patients undergoing a modified De Vega annuloplasty have had a gradual increase in tricuspid regurgitation and clinical manifestations late after the operation. In contrast, all 5 patients with atrial septal defects with a tricuspid annular diameter of >/=50 mm have shown remarkable improvement, similar to those with a tricuspid annular diameter of <50 mm. Preoperative analyses revealed that the right heart function in atrial septal defects had not deteriorated to the same extent as in valvular heart disease. CONCLUSION: In the patients with a severely dilated tricuspid anulus (>/=50 mm), the postoperative change of tricuspid regurgitation differed between those patients with valvular heart disease and atrial septal defects.
Authors:
T Sugimoto; M Okada; N Ozaki; T Hatakeyama; T Kawahira
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of thoracic and cardiovascular surgery     Volume:  117     ISSN:  0022-5223     ISO Abbreviation:  J. Thorac. Cardiovasc. Surg.     Publication Date:  1999 Mar 
Date Detail:
Created Date:  1999-03-18     Completed Date:  1999-03-18     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0376343     Medline TA:  J Thorac Cardiovasc Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  463-71     Citation Subset:  AIM; IM    
Affiliation:
Department of Surgery, Division II, Kobe University School of Medicine, Kobe, Japan.
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MeSH Terms
Descriptor/Qualifier:
Cardiac Output, Low / etiology
Echocardiography, Doppler
Female
Follow-Up Studies
Heart Septal Defects, Atrial / complications*,  physiopathology
Heart Valve Prosthesis Implantation
Hemodynamics
Humans
Male
Middle Aged
Postoperative Complications
Tricuspid Valve / surgery
Tricuspid Valve Insufficiency / complications,  physiopathology,  surgery*

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


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