Abstract
BackgroundThe efficacies of tricuspid valve repair, risk factors for treatment failure and postoperative quality of life have not been thoroughly evaluated in patients with tricuspid insufficiency associated with rheumatic heart disease (RHD). We therefore reviewed our experience with ring and non-ring tricuspid annuloplasty for the treatment of functional tricuspid insufficiency (TI) in RHD.MethodsThis retrospective, follow-up study involved 74 RHD patients who underwent either non-ring annuloplasty (De Vega procedure; 34 patients, 45.95 %) or ring annuloplasty (40 patients, 54.05 %) along with concurrent mitral or/and aortic valve replacement. Operation time, cardiopulmonary bypass time, aortic clamping time, intensive care unit stay and extubation time were recorded. Echocardiographic findings and Short Form (SF)-36 scores were compared between the two groups.ResultsIn hospital mortality and complications were similar in the two study groups (P = 0.6755). At 1 week, 1 month, 6 months, 1 year, 2 years and even longer after the operation, the Kaplan–Meier curve of freedom from mild and above recurrent TI showed significantly better efficacy in the ring annuloplasty group than the De Vega procedure group (log rank P = 0.0377). Risk factors for recurrent TI included high pulmonary artery systolic pressure (PASP) and non-ring annuloplasty (PASP: hazard ratio = 1.52; non-ring: hazard ratio = 1.42). The mental component summary score at 1 year after the operation did not significantly differ between the two groups (P = 0.6446), but the physical component summary score was significantly better in the ring annuloplasty group (P = 0.0037).ConclusionCompared with non-ring annuloplasty, ring annuloplasty was associated with improved survival, decreased TI recurrence and higher quality of life in RHD patients undergoing tricuspid valve repair combined with mitral and/or aortic valve replacement.
Highlights
The efficacies of tricuspid valve repair, risk factors for treatment failure and postoperative quality of life have not been thoroughly evaluated in patients with tricuspid insufficiency associated with rheumatic heart disease (RHD)
Patients From March 2009 to September 2012, a total of 74 patients diagnosed with valve disease of rheumatic etiology, significant heart failure (New York Heart Association [NYHA] class, II–IV) and marked tricuspid insufficiency (TI) underwent tricuspid annuloplasty, which was performed by the same surgeon, in our institution
No significant difference was found between the groups in terms of age, NYHA class, left atrial size, left ventricular ejection fraction, pulmonary artery systolic pressure (PASP), and occurrence rate of TI
Summary
The efficacies of tricuspid valve repair, risk factors for treatment failure and postoperative quality of life have not been thoroughly evaluated in patients with tricuspid insufficiency associated with rheumatic heart disease (RHD). We reviewed our experience with ring and non-ring tricuspid annuloplasty for the treatment of functional tricuspid insufficiency (TI) in RHD. The tricuspid valve insufficiency in RHD patients may worsen over time, leading to severe symptoms, advanced. Tricuspid valve repair is beneficial for treating severe TI in patients requiring mitral valve surgery, according to the 2006 guidelines of the American College of Cardiology/. Studies on the repair of functional TI have shown potential advantages of ring annuloplasty [9], the efficacy of these techniques in rheumatic TI, the risk factors for treatment failure and the resultant quality of life have not yet been thoroughly evaluated
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
