Recovery Of Right Ventricular Function After Tricuspid Annuloplasty For Functional Tricuspid Regurgitation In Patients Undergoing Mitral Valve Repair For Mitral Regurgitation
Yukikatsu Okada, Ryousuke Funahashi, Takashi Muro, Hitoshi Inanami, Tomoyuki Takemoto, Megumi Takahashi, Fumiaki Maenishi.
Midori Hospital, Kobe, Japan.
OBJECTIVE: Moderate to severe functional tricuspid regurgitation (TR) has a negative impact on survival and event free survival. Recovery process of right ventricular (RV) function after successful tricuspid annuloplasty for functional TR is not well analyzed.
METHODS: We assessed left and right ventricular function in 26 patients undergoing mitral valve repair for severe mitral regurgitation only (group A) and mitral valve repair with tricuspid annuloplasty for functional TR (group B). Mean age of the patients was 65±14 years old (male 20, 74%). Left ventricular function (LAEDD, LVESD, LVEF) and right ventricular function (right ventricular diastolic dimension, fractional area change, grade of functional TR, tricuspid annular dilatation) were measured before and one-year after surgery.
RESULTS: There were significant differences in LVEF (68±5%, 54±12%, p=0.019), RV diastolic dimension (32±3mm, 38±5mm, p=0.03), RVp (22±2 mmHg, 38±18mmHg, p=0.047) between group A and group B before surgery. Grade of TR and tricuspid annulus were also significantly larger in group B. One year after surgery, LVEDD, LVESD LVEF, grade of functional TR were not significantly different between two groups. RV dimension significantly reduced in both groups (group A: 32±3mm to 27±4 mm, p=0.0012, group B: 38±11mm to 33±5mm, p=0.006) one year after surgery. There was still significant difference in RV dimension between two groups. Postoperative FAC was significantly larger in group A (45±6 %, 36±8%, p=0.026).
CONCLUSIONS: RV function was significantly improved in patient who underwent concomitant tricuspid annuloplasty for functional TR one year after surgery. RV diastolic size and FAC were not favorably comparable to those patients who did not require tricuspid surgery.
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