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. 2023 Jun 16;12(12):4093.
doi: 10.3390/jcm12124093.

The Early Effects on Tricuspid Annulus and Right Chambers Dimensions in Successful Tricuspid Valve Bicuspidization

Gintarė Bieliauskienė  1 , Ieva Kažukauskienė  1 , Vilius Janušauskas  1 , Aleksejus Zorinas  1 , Kęstutis Ručinskas  1 , Antanas Mainelis  2 , Diana Zakarkaitė  1
Affiliations

The Early Effects on Tricuspid Annulus and Right Chambers Dimensions in Successful Tricuspid Valve Bicuspidization

Gintarė Bieliauskienė et al. J Clin Med. .

Abstract

Background: It is unclear to what degree of tricuspid annulus (TA) reduction is necessary to achieve good postoperative results in surgical bicuspidization. The study aimed to evaluate TA and right heart chamber's dimensions before and after heart surgery; and to compare TA parameters assessed by different modalities.

Methods: Forty patients underwent mitral valve surgery with or without concomitant tricuspid valve (TV) bicuspidization. Preoperative and postoperative measurements of TA dimensions were performed prospectively using two-dimensional (2D) and three-dimensional (3D) transthoracic echocardiography (TTE). Additionally, preoperative transesophageal echocardiography (TOE) was performed in the operating room prior to surgery.

Results: All patients had no or mild TR immediately after surgery. There was a significant reduction in 2D and 3D parameters of the TV and right chambers in the TV bicuspidization group. However, TV leaflets' tethering parameters did not change significantly. Preoperative 3D TTE measurements were smaller than those obtained through 3D TOE in the operation room, before surgery under general anesthesia. The 2D systolic apical 4Ch diameter and the parasternal short axis diameter mainly represent the 3D minor axis of the TA and are smaller than its 3D major axis.

Conclusions: Although bicuspidization results in a one-third reduction of the TV area, tethering of the TV leaflets remains unchanged. Moreover, 3D TOE parameters of the TV under general anesthesia are larger than preoperative 3D TTE measurements. Conventional 2D measurements are insufficient for evaluating the maximum diameter of the TA.

Keywords: bicuspidization; three-dimensional echocardiography; tricuspid annulus; tricuspid valve quantification.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
The steps of bicuspidization.
Figure 2
Figure 2
The TA parameters changes after the bicuspidization; *—p-value < 0.005.
Figure 3
Figure 3
Correlation between 2D and 3D echocardiographic TA measurements.
Figure 4
Figure 4
Correlation between RA area, RV basal diameter and 3D TA measurements.
See this image and copyright information in PMC

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