|
|
||||||||
J Thorac Cardiovasc Surg 2004;127:674-685
© 2004 The American Association for Thoracic Surgery
Surgery for acquired cardiovascular disease |
a Department of Thoracic and Cardiovascular Surgery, The Cleveland Clinic Foundation, Cleveland, Ohio, USA
Read at the Eighty-third Annual Meeting of The American Association for Thoracic Surgery, Boston, Mass, May 4-7, 2003.
Received for publication May 5, 2003; revisions received November 3, 2003; accepted for publication November 10, 2003.
* Address for reprints: Patrick M. McCarthy, MD, Department of Thoracic and Cardiovascular Surgery, 9500 Euclid Ave, Desk F24, Cleveland, OH 44195, USA
mccartp{at}ccf.org
OBJECTIVES: To compare durability of tricuspid valve annuloplasty techniques, identify risk factors for repair failure, and characterize survival, reoperation, and functional class of surviving patients.
METHODS: From 1990 to 1999, 790 patients (mean age 65 ± 12 years, 51% New York Heart Association functional class III or IV, and mean right ventricular systolic pressure 56 ± 18 mm Hg) underwent tricuspid valve annuloplasty for functional regurgitation using 4 techniques: Carpentier-Edwards semi-rigid ring, Cosgrove-Edwards flexible band, De Vega procedure, and customized semicircular Peri-Guard annuloplasty. Of these patients, 89% had concomitant mitral valve surgery. A total of 2245 follow-up transthoracic echocardiograms were retrieved. Tricuspid regurgitation was analyzed, and risk factors for worsening regurgitation were identified, by multivariable ordinal longitudinal methods.
RESULTS: Tricuspid regurgitation 1 week after annuloplasty was 3+ or 4+ in 14% of patients. Regurgitation severity was stable across time with the Carpentier-Edwards ring (P = .7), increased slowly with the Cosgrove-Edwards band (P = .05), and rose more rapidly with the De Vega (P = .002) and Peri-Guard (P = .0009) procedures. Risk factors for worsening regurgitation included higher preoperative regurgitation grade, poor left ventricular function, permanent pacemaker, and repair type other than ring annuloplasty. Right ventricular systolic pressure, ring size, preoperative New York Heart Association functional class, and concomitant surgery were not risk factors. Tricuspid reoperation was rare (3% at 8 years), and hospital mortality after reoperation was 37%.
CONCLUSIONS: Tricuspid valve annuloplasty did not consistently eliminate functional regurgitation, and across time regurgitation increased importantly after Peri-Guard and De Vega annuloplasties. Therefore, these repair techniques should be abandoned, and transtricuspid pacing leads should be replaced with epicardial leads.
This article has been cited by other articles:
![]() |
A. M. Calafiore, A. L. Iaco, M. Contini, and M. Di Mauro A single-size band, 50 mm long, for tricuspid annuloplasty Eur. J. Cardiothorac. Surg., September 1, 2008; 34(3): 677 - 679. [Abstract] [Full Text] [PDF] |
||||
![]() |
T. Guenther, C. Noebauer, D. Mazzitelli, R. Busch, P. Tassani-Prell, and R. Lange Tricuspid valve surgery: a thirty-year assessment of early and late outcome Eur. J. Cardiothorac. Surg., August 1, 2008; 34(2): 402 - 409. [Abstract] [Full Text] [PDF] |
||||
![]() |
J. M. Bernal, A. Ponton, B. Diaz, J. Llorca, I. Garcia, A. Sarralde, C. Diago, and J. M. Revuelta Surgery for rheumatic tricuspid valve disease: a 30-year experience. J. Thorac. Cardiovasc. Surg., August 1, 2008; 136(2): 476 - 481. [Abstract] [Full Text] [PDF] |
||||
![]() |
E. C. McGee Jr, R. Lee, S. C. Malaisrie, and P. M. McCarthy Tricuspid valve annuloplasty for functional regurgitation MMCTS, May 23, 2008; 2008(0523): 2766. [Abstract] [Full Text] [PDF] |
||||
![]() |
U. Kappert, S.-M. Tugtekin, A. Ouda, K. Alexiou, A. Schmeisser, S. Schoen, and K. Matschke Right ventricular reduction as an adjunct procedure in tricuspid valve repair. Ann. Thorac. Surg., May 1, 2008; 85(5): e27 - e29. [Abstract] [Full Text] [PDF] |
||||
![]() |
M. De Bonis, E. Lapenna, F. Sorrentino, G. La Canna, A. Grimaldi, F. Maisano, L. Torracca, and O. Alfieri Evolution of tricuspid regurgitation after mitral valve repair for functional mitral regurgitation in dilated cardiomyopathy Eur. J. Cardiothorac. Surg., April 1, 2008; 33(4): 600 - 606. [Abstract] [Full Text] [PDF] |
||||
![]() |
H. M. Russell, P. M. McCarthy, R. Lee, S. C. Malaisrie, and E. C. McGee Jr Jr Tricuspid valve replacement with a bioprosthetic valve MMCTS, March 28, 2008; 2008(0328): 2774. [Abstract] [Full Text] [PDF] |
||||
![]() |
S. Tokunaga, M. Masuda, A. Shiose, Y. Tomita, S. Morita, and R. Tominaga Long-Term Results of Isolated Tricuspid Valve Replacement Asian Cardiovasc Thorac Ann, February 1, 2008; 16(1): 25 - 28. [Abstract] [Full Text] [PDF] |
||||
![]() |
M. Enriquez-Sarano, V. T. Nkomo, and H. Michelena Principles and Practice of Echocardiography in Cardiac Surgery Card. Surg. Adult, January 1, 2008; 3(2008): 315 - 348. [Full Text] |
||||
![]() |
R. J. Shemin Tricuspid Valve Disease Card. Surg. Adult, January 1, 2008; 3(2008): 1111 - 1128. [Full Text] |
||||
![]() |
G. Gatti, F. Marciano, F. Antonini-Canterin, B. Pinamonti, B. Benussi, A. Pappalardo, and B. Zingone Tricuspid valve annuloplasty with a flexible prosthetic band Interactive CardioVascular and Thoracic Surgery, December 1, 2007; 6(6): 731 - 735. [Abstract] [Full Text] [PDF] |
||||
![]() |
J. Kwan, G.-C. Kim, M.-J. Jeon, D.-H. Kim, T. Shiota, J. D. Thomas, K.-S. Park, and W.-H. Lee 3D geometry of a normal tricuspid annulus during systole: A comparison study with the mitral annulus using real-time 3D echocardiography Eur J Echocardiogr, October 1, 2007; 8(5): 375 - 383. [Abstract] [Full Text] [PDF] |
||||
![]() |
M. J Antunes and J. B Barlow Management of tricuspid valve regurgitation Heart, February 1, 2007; 93(2): 271 - 276. [Full Text] [PDF] |
||||
![]() |
R. K. Ghanta, R. Chen, N. Narayanasamy, S. McGurk, S. Lipsitz, F. Y. Chen, and L. H. Cohn Suture bicuspidization of the tricuspid valve versus ring annuloplasty for repair of functional tricuspid regurgitation: Midterm results of 237 consecutive patients J. Thorac. Cardiovasc. Surg., January 1, 2007; 133(1): 117 - 126. [Abstract] [Full Text] [PDF] |
||||
![]() |
S. K. Singh, G. H.L. Tang, M. D. Maganti, S. Armstrong, W. G. Williams, T. E. David, and M. A. Borger Midterm Outcomes of Tricuspid Valve Repair Versus Replacement for Organic Tricuspid Disease Ann. Thorac. Surg., November 1, 2006; 82(5): 1735 - 1741. [Abstract] [Full Text] [PDF] |
||||
![]() |
R. O. Bonow, B. A. Carabello, K. Chatterjee, A. C. de Leon Jr, D. P. Faxon, M. D. Freed, W. H. Gaasch, B. W. Lytle, R. A. Nishimura, P. T. O'Gara, et al. ACC/AHA 2006 Guidelines for the Management of Patients With Valvular Heart Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 1998 Guidelines for the Management of Patients With Valvular Heart Disease) Developed in Collaboration With the Society of Cardiovascular Anesthesiologists Endorsed by the Society for Cardiovascular Angiography and Interventions and the Society of Thoracic Surgeons J. Am. Coll. Cardiol., August 1, 2006; 48(3): e1 - e148. [Full Text] [PDF] |
||||
![]() |
R. O. Bonow, B. A. Carabello, K. Chatterjee, A. C. de Leon Jr, D. P. Faxon, M. D. Freed, W. H. Gaasch, B. W. Lytle, R. A. Nishimura, P. T. O'Gara, et al. ACC/AHA 2006 Practice Guidelines 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 (Writing Committee to Revise the 1998 Guidelines for the Management of Patients With Valvular Heart Disease) Developed in Collaboration With the Society of Cardiovascular Anesthesiologists Endorsed by the Society for Cardiovascular Angiography and Interventions and the Society of Thoracic Surgeons J. Am. Coll. Cardiol., August 1, 2006; 48(3): 598 - 675. [Full Text] [PDF] |
||||
![]() |
T.-T. Ton-Nu, R. A. Levine, M. D. Handschumacher, D. J. Dorer, C. Yosefy, D. Fan, L. Hua, L. Jiang, and J. Hung Geometric Determinants of Functional Tricuspid Regurgitation: Insights From 3-Dimensional Echocardiography Circulation, July 11, 2006; 114(2): 143 - 149. [Abstract] [Full Text] [PDF] |
||||
![]() |
S. Fukuda, G. Saracino, Y. Matsumura, M. Daimon, H. Tran, N. L. Greenberg, T. Hozumi, J. Yoshikawa, J. D. Thomas, and T. Shiota Three-Dimensional Geometry of the Tricuspid Annulus in Healthy Subjects and in Patients With Functional Tricuspid Regurgitation: A Real-Time, 3-Dimensional Echocardiographic Study Circulation, July 4, 2006; 114(1_suppl): I-492 - I-498. [Abstract] [Full Text] [PDF] |
||||
![]() |
G. H. L. Tang, T. E. David, S. K. Singh, M. D. Maganti, S. Armstrong, and M. A. Borger Tricuspid Valve Repair With an Annuloplasty Ring Results in Improved Long-Term Outcomes Circulation, July 4, 2006; 114(1_suppl): I-577 - I-581. [Abstract] [Full Text] [PDF] |
||||
![]() |
S. Fukuda, A. M. Gillinov, P. M. McCarthy, W. J. Stewart, J.-M. Song, T. Kihara, M. Daimon, M.-S. Shin, J. D. Thomas, and T. Shiota Determinants of Recurrent or Residual Functional Tricuspid Regurgitation After Tricuspid Annuloplasty Circulation, July 4, 2006; 114(1_suppl): I-582 - I-587. [Abstract] [Full Text] [PDF] |
||||
![]() |
Y.-Q. Lai, X. Meng, T. Bai, C. Zhang, Y. Luo, and Z.-G. Zhang Edge-to-Edge Tricuspid Valve Repair: An Adjuvant Technique for Residual Tricuspid Regurgitation Ann. Thorac. Surg., June 1, 2006; 81(6): 2179 - 2182. [Abstract] [Full Text] [PDF] |
||||
![]() |
F. Filsoufi, S. P. Salzberg, M. Coutu, and D. H. Adams A Three-Dimensional Ring Annuloplasty for the Treatment of Tricuspid Regurgitation Ann. Thorac. Surg., June 1, 2006; 81(6): 2273 - 2277. [Abstract] [Full Text] [PDF] |
||||
![]() |
S. K. Bhudia, D. M. Cosgrove, R. I. Naugle, J. Rajeswaran, B.-K. Lam, E. Walton, J. Petrich, R. C. Palumbo, A. M. Gillinov, C. Apperson-Hansen, et al. Magnesium as a neuroprotectant in cardiac surgery: A randomized clinical trial J. Thorac. Cardiovasc. Surg., April 1, 2006; 131(4): 853 - 861. [Abstract] [Full Text] [PDF] |
||||
![]() |
A. Matsunaga and C. M. G. Duran Progression of Tricuspid Regurgitation After Repaired Functional Ischemic Mitral Regurgitation Circulation, August 30, 2005; 112(9_suppl): I-453 - I-457. [Abstract] [Full Text] [PDF] |
||||
![]() |
J. M. Bernal, D. Morales, C. Revuelta, J. Llorca, J. Gutierrez-Morlote, and J. M. Revuelta Reoperations after tricuspid valve repair J. Thorac. Cardiovasc. Surg., August 1, 2005; 130(2): 498 - 503. [Abstract] [Full Text] [PDF] |
||||
![]() |
R. H. Jones The Year in Cardiovascular Surgery J. Am. Coll. Cardiol., May 3, 2005; 45(9): 1517 - 1528. [Full Text] [PDF] |
||||
![]() |
S. Fukuda, J.-M. Song, A. M. Gillinov, P. M. McCarthy, M. Daimon, V. Kongsaerepong, J. D. Thomas, and T. Shiota Tricuspid Valve Tethering Predicts Residual Tricuspid Regurgitation After Tricuspid Annuloplasty Circulation, March 1, 2005; 111(8): 975 - 979. [Abstract] [Full Text] [PDF] |
||||
![]() |
J. M. Bernal, J. Gutierrez-Morlote, J. Llorca, J. M. San Jose, D. Morales, and J. M. Revuelta Tricuspid Valve Repair: An Old Disease, a Modern Experience Ann. Thorac. Surg., December 1, 2004; 78(6): 2069 - 2074. [Abstract] [Full Text] [PDF] |
||||
![]() |
M. Carrier INVITED COMMENTARY Ann. Thorac. Surg., December 1, 2004; 78(6): 2074 - 2075. [Full Text] [PDF] |
||||
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| ANN THORAC SURG | ASIAN CARDIOVASC THORAC ANN | EUR J CARDIOTHORAC SURG |
| J THORAC CARDIOVASC SURG | ICVTS | ALL CTSNet JOURNALS |