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Daniel Marelli
Fardad Esmailian
Murray H. Kwon
Ramin E. Beygui
Hillel Laks
Mark D. Plunkett
Abbas Ardehali
Richard J. Shemin
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J Thorac Cardiovasc Surg 2009;137:1557-1559
© 2009 The American Association for Thoracic Surgery

Brief Communication

Tricuspid valve regurgitation after heart transplantation

Daniel Marelli, MD, Fardad Esmailian, MD*, Samantha Y. Wong, BS, Jon A. Kobashigawa, MD, Murray H. Kwon, MD, Ramin E. Beygui, MD, Hillel Laks, MD, Mark D. Plunkett, MD, Abbas Ardehali, MD, Richard J. Shemin, MD

Heart Transplant Program, David Geffen School of Medicine at the University of California, Los Angeles, Calif

Received for publication April 15, 2008; revisions received August 29, 2008; accepted for publication September 1, 2008.

* Address for reprints: Fardad Esmailian, MD, Department of Surgery, Division of Cardiothoracic Surgery, the University of California at Los Angeles, 18033 Le Conte Ave, 62-266-CHS, Los Angeles, CA 90095-1741. (Email: fesmailian@mednet.ucla.edu).

The first 20% of the full text of this article appears below.

Tricuspid valve regurgitation (TR) after orthotopic heart transplantation (OHT) is of concern owing to its correlation with right ventricular dysfunction and mortality.1Go

Studies show that the bicaval anastomosis technique decreases the incidence TR when compared with biatrial techniques.2Go More recent studies show that modified surgical techniques, such as tricuspid valve annuloplasty or a modified inferior vena cava anastomosis, may alleviate moderate and severe TR after transplantation.3,4Go

This study examines the long-term natural history of TR after OHT.

Patients and Methods

From January 1997 to December 2005, 670 consecutive adults underwent heart transplantation with the bicaval anastomosis technique. The mean age was 53.4 ± 13.2 years (range, 18.3–70.5). The male recipients comprised 69.4% of the cohort. The etiology of cardiomyopathy before OHT was idiopathic dilated (45%), ischemic (39%), retransplant (6%), or other (10%). The mean ischemic time was 212.8 ± 71.4 minutes.

Donor hearts were flushed with a cold University of Wisconsin solution and reperfused with leukocyte-depleted blood.

Both routine echocardiogram reports and those monitoring clinical changes were . . . [Full Text of this Article]






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