Skip to main content
SpringerLink
Log in

Mid-term functional recovery after tricuspid annuloplasty concomitant with left-sided valve surgery

  • Original Article
  • Published:
General Thoracic and Cardiovascular Surgery Aims and scope Submit manuscript

Abstract

Background

To elucidate the impact of tricuspid annuloplasty concomitant with left-sided valve surgery on the right ventricular (RV) function in patients with mild or more tricuspid regurgitation (TR).

Methods

We enrolled 136 patients with mild or more TR who underwent left-sided valve surgery. Seventy-three patients underwent left-sided valve surgery alone (group non-T) and 63 underwent concomitant tricuspid annuloplasty (group T). The echocardiographic data at the latest follow-up (mean 1019 days) were compared using multiple regression analysis to adjust cofounding factors. Propensity score was calculated and included in the analysis as a covariate. In addition, propensity score matching was used for sensitive analysis (12 pairs).

Results

In group non-T, there were more aortic valve surgeries, and fewer mitral valve surgeries. At baseline, body surface area, New York Heart Association class, and prevalence of atrial fibrillation were significantly different between groups. On preoperative echocardiography, left and right atrial diameter, RV diameter, and tricuspid annular diameter were larger in group T, whereas there was no significant difference in RV fractional area change. In multiple regression analyses, RV diameter in diastole was significantly lower and RV fractional area change was significantly higher at the follow-up period in group T. These results were not attenuated even in subgroup analysis in patients with only mild TR or mitral valve surgery alone.

Conclusion

Among patients with mild or more TR, RV dimensional and functional recovery was not obtained with left-sided valve surgery alone. Adding tricuspid annuloplasty may potentially achieve both outcomes.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Van de Veire NR, Braun J, Delgado V, et al. Tricuspid annuloplasty prevents right ventricular dilatation and progression of tricuspid regurgitation in patients with tricuspid annular dilatation undergoing mitral valve repair. J Thorac Cardiovasc Surg. 2011;141:1431–9.

    Article  Google Scholar 

  2. Lee H, Sung K, Kim WS, et al. Clinical and hemodynamic influences of prophylactic tricuspid annuloplasty in mechanical mitral valve replacement. J Thorac Cardiovasc Surg. 2016;151:788–95.

    Article  Google Scholar 

  3. Desai RR, Vargas Abello LM, Klein AL, et al. Tricuspid regurgitation and right ventricular function after mitral valve surgery with or without concomitant tricuspid valve procedure. J Thorac Cardiovasc Surg. 2013;146:1126–212.

    Article  Google Scholar 

  4. Ye Y, Desai R, Vargas Abello LM, et al. Effects of right ventricular morphology and function on outcomes of patients with degenerative mitral valve disease. J Thorac Cardiovasc Surg. 2014;148:2012–20.

    Article  Google Scholar 

  5. Malinowski M, Jazwiec T, Goehler M, et al. Sonomicrometry-derived 3-dimensional geometry of the human tricuspid annulus. J Thorac Cardiovasc Surg. 2019;157:1452–61.

    Article  Google Scholar 

  6. Kawada N, Naganuma H, Muramatsu K, Ishibashi-Ueda H, Bando K, Hashimoto K. Redefinition of tricuspid valve structures for successful ring annuloplasty. J Thorac Cardiovasc Surg. 2018;155:1511–9.

    Article  Google Scholar 

  7. Jazwiec T, Malinowski M, Proudfoot AG, et al. Tricuspid valvular dynamics and 3-dimensional geometry in awake and anesthetized sheep. J Thorac Cardiovasc Surg. 2018;156:1503–11.

    Article  Google Scholar 

  8. Nishimura RA, Otto CM, Bonow RO, et al. 2014 AHA/ACC guideline 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. Circulation. 2014;148:e1–132.

    Google Scholar 

  9. Vahanian A, Alfieri O, Andreotti F, et al. Guidelines on the management of valvular heart disease (version 2012): the joint task force on the management of valvular heart disease of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS). Eur J Cardiothorac Surg. 2012;42:S1–44.

    Article  Google Scholar 

  10. Dreyfus GD, Corbi PJ, Chan J, Bahrami T. Secondary tricuspid regurgitation or dilatation: which should be the criteria for surgical repair? Ann Thorac Surg. 2005;79:127–32.

    Article  Google Scholar 

  11. Sakata T, Mogi K, Sakurai M, et al. Effect of tricuspid annuloplasty concomitant with left heart surgery on right heart geometry and function. J Thorac Cardiovasc Surg. 2018;156:1050–61.

    Article  Google Scholar 

  12. Chikwe J, Itagaki S, Anyanwu A, Adams DH. Impact of concomitant tricuspid annuloplasty on tricuspid regurgitation, right ventricular function, and pulmonary artery hypertension after repair of mitral valve prolapse. J Am Coll Cardiol. 2015;65:1931–8.

    Article  Google Scholar 

  13. Kim HK, Kim YJ, Park JS, et al. Determinants of the severity of functional tricuspid regurgitation. Am J Cardiol. 2006;98:236–42.

    Article  Google Scholar 

  14. Galderisi M, Cosyns B, Edvardsen T, et al. Standardization of adult transthoracic echocardiography reporting in agreement with recent chamber quantification, diastolic function, and heart valve disease recommendations: an expert consensus document of the European Association of Cardiovascular Imaging. Eur Heart J Cardiovasc Imaging. 2017;18:1301–10.

    Article  Google Scholar 

  15. Lang RM, Badano LP, Mor-Avi V, et al. Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogr. 2015;28(1–39):e14.

    Google Scholar 

  16. Baumgartner H, Falk V, Bax JJ, et al. 2017 ESC/EACTS Guidelines for the management of valvular heart disease. Eur Heart J. 2017;38:2739–91.

    Article  Google Scholar 

  17. Wang J, Han J, Li Y, et al. Impact of surgical ablation of atrial fibrillation on the progression of tricuspid regurgitation and right-sided heart remodeling after mitral-valve surgery: a propensity-score matching analysis. J Am Heart Assoc. 2016;5:e004213.

    PubMed  PubMed Central  Google Scholar 

  18. Kim HK, Kim YJ, Kim KI, et al. Impact of the maze operation combined with left-sided valve surgery on the change in tricuspid regurgitation over time. Circulation. 2005;112(Suppl):I14–19.

    PubMed  Google Scholar 

  19. De Bonis M, Lapenna E, Sorrentino F, et al. Evolution of tricuspid regurgitation after mitral valve repair for functional mitral regurgitation in dilated cardiomyopathy. Eur J Cardiothorac Surg. 2008;33:600–6.

    Article  Google Scholar 

  20. Jazwiec T, Malinowski M, Bush J, et al. Right ventricular free wall stress after tricuspid valve annuloplasty in acute ovine right heart failure. J Thorac Cardiovasc Surg. 2019;158:759–68.

    Article  Google Scholar 

  21. Zhu TY, Wang JG, Meng X. Does concomitant tricuspid annuloplasty increase perioperative mortality and morbidity when correcting left-sided valve disease? Interact Cardiovasc Thorac Surg. 2015;20:114–8.

    Article  Google Scholar 

  22. Mihos CG, Pineda AM, Davila H, Larrauri-Reyes MC, Santana O. Combined mitral and tricuspid valve surgery performed via a right minithoracotomy approach. Innovations (Phila). 2015;10:304–8.

    Article  Google Scholar 

  23. Ricci D, Boffini M, Barbero C, El Qarra S, Marchetto G, Rinaldi M. Minimally invasive tricuspid valve surgery in patients at high risk. J Thorac Cardiovasc Surg. 2014;147:996–1001.

    Article  Google Scholar 

  24. Lee TC, Desai B, Glower DD. Results of 141 consecutive minimally invasive tricuspid valve operations: an 11 year experience. Ann Thorac Surg. 2009;88:1845–50.

    Article  Google Scholar 

Download references

Funding

K Matsuura and G Matsumiya received research funding from Edwards Lifesciences Corporation and Medtronic Japan Co., Ltd.

Author information

Authors and Affiliations

  1. Division of Cardiovascular Surgery, Heart and Vascular Institute, Funabashi Municipal Medical Center, 1-21-1 Kanasugi, Chiba, Funabashi, 273-8588, Japan

    Tomoki Sakata, Kenji Mogi, Manabu Sakurai & Yoshiharu Takahara

  2. Department of Cardiovascular Surgery, Chiba University Hospital, Chiba, Japan

    Tomoki Sakata, Kaoru Matsuura & Goro Matsumiya

  3. Biostatistics Section, Clinical Research Center, Chiba University Hospital, Chiba, Japan

    Yuki Shiko & Yohei Kawasaki

Authors
  1. Tomoki Sakata
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Kenji Mogi
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Kaoru Matsuura
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Manabu Sakurai
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Yuki Shiko
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Yohei Kawasaki
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Goro Matsumiya
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Yoshiharu Takahara
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Tomoki Sakata.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Electronic supplementary material

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Sakata, T., Mogi, K., Matsuura, K. et al. Mid-term functional recovery after tricuspid annuloplasty concomitant with left-sided valve surgery. Gen Thorac Cardiovasc Surg 69, 662–672 (2021). https://doi.org/10.1007/s11748-020-01501-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11748-020-01501-4

Keywords

Search

Navigation