Abstract 13860: Prognostic Implication of Biventricular Global Longitudinal Strain in Patients Undergoing Tricuspid Valve Surgery for Severe Isolated Tricuspid Regurgitation

Abstract

Introduction: Isolated tricuspid valve (TV) surgery can be performed for patients with symptoms due to severe isolated tricuspid regurgitation (TR), preferentially before the onset of significant right ventricular (RV) dysfunction. In patients with severe TR, chronic RV volume overload may mask intrinsic myocardial dysfunction. Ultimately, RV dysfunction promotes LV underfilling, which can lead to left ventricular (LV) mechanical dysfunction. Hypothesis: Pre and postoperative biventricular global longitudinal strain (GLS) would give prognostic information in patients with isolated severe TR. Methods: In 117 patients who underwent TV surgery with severe isolated TR in a single tertiary center, we comprehensively assessed LV, RV, and biventricular global longitudinal strain (GLS) by speckle tracking echocardiography before and at least 1 month after TV surgery. Biventricular GLS was defined as a summation of LV-GLS and RV free wall strain. Patients with a history of open-heart surgery, severe left-side valve disease, reduced LV ejection fraction, and who underwent concomitant coronary artery bypass surgery were not included. Primary outcomes were defined as a composite of death, heart failure hospitalization, re-do TV surgery, and heart transplantation. Results: During a mean of 4.3 ± 3.9 years after TV surgery, 26 patients (22.2%) had experienced primary outcomes. In patients with primary outcomes, a previous history of diabetes mellitus and atrial fibrillation were more common, and