Unbound MEDLINE

Surgical treatment of tricuspid regurgitation after mitral valve surgery: a retrospective study in China.

Abstract

BACKGROUND
Functional tricuspid regurgitation (TR) occurs in patients with rheumatic mitral valve disease even after mitral valve surgery. The aim of this study was to analyze surgical results of TR after previous successful mitral valve surgery.
METHODS
From September 1996 to September 2008, 45 patients with TR after previous mitral valve replacement underwent second operation for TR. In those, 43 patients (95.6%) had right heart failure symptoms (edema of lower extremities, ascites, hepatic congestion, etc.) and 40 patients (88.9%) had atrial fibrillation. Twenty-six patients (57.8%) were in New York Heart Association (NYHA) functional class III, and 19 (42.2%) in class IV. Previous operations included: 41 for mechanical mitral valve replacement (91.1%), 4 for bioprosthetic mitral valve replacement (8.9%), and 7 for tricuspid annuloplasty (15.6%).
RESULTS
The tricuspid valves were repaired with Kay's (7 cases, 15.6%) or De Vega technique (4 cases, 8.9%). Tricuspid valve replacement was performed in 34 cases (75.6%). One patient (2.2%) died. Postoperative low cardiac output (LCO) occurred in 5 patients and treated successfully. Postoperative echocardiography showed obvious reduction of right atrium and ventricle. The anterioposterior diameter of the right ventricle decreased to 25.5 ± 7.1 mm from 33.7 ± 6.2 mm preoperatively (P < 0. 05).
CONCLUSION
TR after mitral valve replacement in rheumatic heart disease is a serious clinical problem. If it occurs or progresses late after mitral valve surgery, tricuspid valve annuloplasty or replacement may be performed with satisfactory results. Due to the serious consequence of untreated TR, aggressive treatment of existing TR during mitral valve surgery is recommended.

Links

  • PMC Free PDF
  • PMC Free Full Text
  • FREE Publisher Full Text
  • Authors

    Li ZX, Guo ZP, Liu XC, Kong XR, Jing WB, Chen TN, Lu WL, He GW

    Source

    Journal of cardiothoracic surgery 7: 2012 pg 30

    MeSH

    Adult
    Aged
    Cardiac Valve Annuloplasty
    China
    Female
    Follow-Up Studies
    Heart Valve Prosthesis Implantation
    Humans
    Male
    Middle Aged
    Mitral Valve Insufficiency
    Mitral Valve Stenosis
    Retrospective Studies
    Rheumatic Heart Disease
    Treatment Outcome
    Tricuspid Valve Insufficiency

    Pub Type(s)

    Evaluation Studies
    Journal Article
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    22490269