Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Jun;69(6):911-918.
doi: 10.1007/s11748-020-01536-7. Epub 2020 Nov 6.

Degree of right ventricular dysfunction dictates outcomes after tricuspid valve repair concomitant with left-side valve surgery

Khaled D Algarni  1   2 , Amr Arafat  3   4 , Abdulaziz D Algarni  3 , Juan J Alfonso  5 , Abdulaziz Alhossan  3 , Abdelhameed Elsayed  6 , Hatim M Kheirallah  6 , Turki B Albacker  7
Affiliations

Degree of right ventricular dysfunction dictates outcomes after tricuspid valve repair concomitant with left-side valve surgery

Khaled D Algarni et al. Gen Thorac Cardiovasc Surg. 2021 Jun.

Abstract

Objectives: The effect of different degrees of right ventricular (RV) dysfunction on long-term outcomes after tricuspid valve repair is the subject of ongoing research. We sought to evaluate the effect of preoperative RV dysfunction on mortality and recurrence of tricuspid regurgitation (TR) after tricuspid valve repair for secondary TR concomitant with left-side valve surgery.

Methods: This is a retrospective study, including 548 patients who underwent repair of secondary TR (2009-2017) at a single institution. Patients were grouped according to preoperative right ventricular (RV) systolic function into three groups; normal RV function (group 1, n = 451), mild RV dysfunction (group 2, n = 60) and moderate/severe RV dysfunction (group 3, n = 37). Study endpoints were mortality and recurrence of TR.

Results: Group 3 was associated with the highest hospital mortality (10.2%, p = .06). Predictors of moderate or higher grade TR were NYHA class (HR 2.1, p = 0.03); preoperative TR grade (HR 1.9, p < 0.01), mild RV dysfunction (HR 2.4, p < 0.01), isolated RV dilatation (HR 2.0, p < 0.01), and flexible TV repair prostheses (HR 2.4, p = 0.01). Predictors of mortality were renal impairment (HR 3.0, p < 0.01), ejection fraction (HR 0.97, p = 0.02), pulmonary artery systolic pressure (HR 1.02, p = 0.02), preoperative TR grade (HR 1.7, p < 0.01), and moderate/severe RV dysfunction (HR 3.1, p = 0.01).

Conclusion: Compared to normal and mild degree of RV dysfunction, moderate and severe RV dysfunction were independent predictors of poor long-term survival. Isolated RV dilatation increased the recurrence of TR. RV dysfunction and dilatation could be indications of tricuspid valve repair.

Keywords: Right ventricle dilatation; Right ventricle dysfunction; Tricuspid repair.

PubMed Disclaimer

References

    1. Kammerlander AA, Marzluf BA, Graf A, et al. Right ventricular dysfunction, but not tricuspid regurgitation, is associated with outcome late after left heart valve procedure. J Am Coll Cardiol. 2014;64:2633–42. - DOI
    1. Dietz MF, Prihadi EA, van der Bijl P, et al. Prognostic implications of right ventricular remodeling and function in patients with significant secondary tricuspid regurgitation. Circulation. 2019;140:836–45. - DOI
    1. Rogers JH, Bolling SF. The tricuspid valve: current perspective and evolving management of tricuspid regurgitation. Circulation. 2009;119:2718–25. - DOI
    1. Nath J, Forster E, Heidenreich PA. Impact of tricuspid regurgitation on long term survival. J Am Coll Cardiol. 2004;34:405–9. - DOI
    1. Nishimura RA, Otto CM, Bonow RO, ACC/AHA Task Force Members, et al. 2014 AHA/ACC Guideline for the management of patients with valvular heart disease: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation. 2014;129:2440–92. - DOI

MeSH terms

LinkOut - more resources