Author + information
- Philippe Bertrand,
- Gille Koppers,
- Frederik H. Verbrugge,
- Wilfried Mullens,
- Rozette Reyskens,
- Herbert Gutermann,
- Christiaan J. van Kerrebroeck,
- Robert A. Dion,
- Pieter Vandervoort and
- David Verhaert
Tricuspid valve annuloplasty (TVP) has been advocated concomitantly with complex left–sided cardiac surgery in case of severe functional tricuspid regurgitation (TR) or isolated tricuspid annular dilatation (TAD, diameter > 4,0cm or 2,1cm/m2) in the absence of TR. Data on postoperative right ventricular (RV) remodeling are lacking in these patients.
Pre– and postoperative echocardiographical data from 45 consecutive TVP procedures performed during left–sided cardiac surgery (mainly mitral valve) in a tertiary surgical center were retrospectively analyzed and compared to a contemporary control group of 33 procedures without concomitant TVP. Changes in RV function and geometry were analyzed by measuring RV size, fractional area change and RV end–diastolic sphericity index (RVSI=long–axis length/short–axis width) at baseline and follow–up.
At 4,5 months follow–up, a significant beneficial increase in RVSI was observed in TVP patients (Figure 1), whereas the opposite was seen in the control group. Indexed RV end–diastolic area increased significantly only in the control group, likely due to ongoing adverse remodeling. Postoperative RV fractional area change declined non–significantly in both groups.
Adding TVP to left–sided cardiac surgery in patients with severe TR or isolated TAD leads to favorable changes in RV geometry and prevents ongoing postoperative RV dilation. Adding TVP to complex left–sided surgery has no adverse effect on RV function.
Poster Sessions, Expo North
Monday, March 11, 2013, 9:45 a.m.–10:30 a.m.
Session Title: Optimal Management of Tricuspid Regurgitation and Trends in the Treatment of Endocarditis
Abstract Category: 32. Valvular Heart Disease: Therapy
Presentation Number: 1284–76
- 2013 American College of Cardiology Foundation