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 Jan 26;21(1):50.
doi: 10.1186/s12872-021-01870-5.

Risk factors for postoperative recurrent tricuspid regurgitation after concomitant tricuspid annuloplasty during left heart surgery and the association between tricuspid annular circumference and secondary tricuspid regurgitation

JinGuo Xu  1 , Jie Han  1 , Haibo Zhang  1 , Fei Meng  1 , Tiange Luo  1 , BaiYu Tian  1 , JianGang Wang  1 , YuQing Jiao  1 , HuiMei Yu  2 , Xu Meng  3
Affiliations

Risk factors for postoperative recurrent tricuspid regurgitation after concomitant tricuspid annuloplasty during left heart surgery and the association between tricuspid annular circumference and secondary tricuspid regurgitation

JinGuo Xu et al. BMC Cardiovasc Disord. .

Abstract

Background: To identify the association between tricuspid annular circumference and secondary tricuspid regurgitation and analyze the risk factors of recurrent tricuspid regurgitation after concomitant tricuspid annuloplasty during left heart surgery.

Methods: From October 2018 to June 2019, a total of 117 patients receiving concomitant tricuspid annuloplasty within left heart surgery were enrolled. Severity of tricuspid regurgitation was classified as 4 subtypes: normal, mild, moderate and severe. Perioperative data and mid-term outcome were collected. Tricuspid annular circumference (TAC) was measured under cardiac arrest during surgery procedure by cardioplegia. Optimal TAC and TAC index (TAC/body surface area, BSA) cutoffs of significant tricuspid annulus dilatation (moderate and severe) were obtained. Univariable and multivariable logistic regression analyses were performed to identify the risk factors of postoperative recurrent tricuspid regurgitation. The follow up period is 13-19 months (mean 15.5 ± 3.2 months).

Results: There was 1 patient was excluded who died after surgery. A total of 116 patients receiving tricuspid annuloplasty were included. Optimal cutoffs of significant tricuspid annulus dilatation were recommended (TAC 11.45 cm, Sensitivity 82.89%, Specificity 73.68%, AUC 0.915; TAC index 7.09 cm/m2, Sensitivity 73.68%, Specificity 85%, AUC 0.825, respectively). Based on findings of multivariable logistic regression, it has been showed that TAC index and postoperative atrial fibrillation were the independent risk factors of recurrent regurgitation after surgery. Optimal TAC index cutoff to predict recurrent tricuspid regurgitation was 7.86 cm/m2 CONCLUSIONS: The severity of secondary tricuspid regurgitation is associated with the tricuspid annular circumference. The cut-offs of significant tricuspid regurgitation (more than moderate) were TAC 11.45 cm and TAC index 7.09 cm/m2, respectively. Clinically, concomitant tricuspid annuloplasty is relative safe and effective. TAC index ≥ 7.86 cm/m2 and postoperative atrial fibrillation are the risk factors of recurrent significant tricuspid regurgitation after concomitant tricuspid annuloplasty during left heart surgery.

Keywords: Tricuspid annular circumference; Tricuspid annuloplasty; Tricuspid regurgitation.

PubMed Disclaimer

Conflict of interest statement

There was no competing interests.

Figures

Fig. 1
Fig. 1
Measurement of tricuspid annulus: a measurement of septal annulus; b measurement of anterior annulus; c measurement of posterior annulus
Fig. 2
Fig. 2
TAC of Receiver-operator curve (ROC) for determining cut-off values to assess tricuspid annulus dilatation
Fig. 3
Fig. 3
TACI of Receiver-operator curve (ROC) for determining cut-off values to assess tricuspid annulus dilatation
Fig. 4
Fig. 4
TACI of Receiver-operator curve (ROC) for predicting recurrent tricuspid regurgitation
See this image and copyright information in PMC

References

    1. Amano M, Izumi C, Taniguchi T, Morimoto T, Miyake M, Nishimura S, et al. Impact of concomitant tricuspid regurgitation on long-term outcomes in severe aortic stenosis. Eur Heart J Cardiovasc Imaging. 2019;20(3):353–360. doi: 10.1093/ehjci/jey105. - DOI - PubMed
    1. Donal E, Galli E, Bidaut A. Advocacy for more consideration of the secondary tricuspid regurgitation. Heart. 2019;105(16):1221–1222. doi: 10.1136/heartjnl-2019-315262. - DOI - PubMed
    1. Arsalan M, Walther T, Smith RL, 2nd, Grayburn PA. Tricuspid regurgitation diagnosis and treatment. Eur Heart J. 2017;38(9):634–638. - PubMed
    1. Izumi C. Isolated functional tricuspid regurgitation: when should we go to surgical treatment? J Cardiol. 2020;75(4):339–343. doi: 10.1016/j.jjcc.2019.11.001. - DOI - PubMed
    1. Sakata T, Mogi K, Sakurai M, Nomura A, Fujii M, Kaneyuki D, et al. Effect of tricuspid annuloplasty concomitant with left heart surgery on right heart geometry and function. J Thorac Cardiovasc Surg. 2018;156(3):1050–1061. doi: 10.1016/j.jtcvs.2018.03.101. - DOI - PubMed

MeSH terms