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01-10-2018 | Original Article | Uitgave 11/2018 Open Access

Netherlands Heart Journal 11/2018

Longitudinal echocardiographic and clinical follow-up of patients undergoing mitral valve surgery without concomitant tricuspid valve repair

Tijdschrift:
Netherlands Heart Journal > Uitgave 11/2018
Auteurs:
R. Jansen, B. R. van Klarenbosch, M. J. Cramer, R. C. A. Meijer, P. H. M. Westendorp, H. W. J. Meijburg, J. J. J. Bucx, S. A. J. Chamuleau, J. Kluin
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Electronic supplementary material

The online version of this article (https://​doi.​org/​10.​1007/​s12471-018-1159-4) contains supplementary material, which is available to authorized users.
The Authors R. Jansen and B.R. van Klarenbosch contributed equally to the manuscript.

Abstract

Background

In patients with mild to moderate functional tricuspid regurgitation (TR) and absence of right ventricular dysfunction or tricuspid annulus (TA) dilatation, there is currently no indication for concomitant tricuspid valve (TV) repair during elective mitral valve (MV) surgery. However, long-term results are conflicting. Here, we sought to determine the clinical outcome of this cohort, the rate of TR progression after MV surgery and the role of MV aetiology.

Methods

Patients for elective MV surgery without concomitant TV repair were retrospectively analysed with longitudinal echocardiographic and clinical follow-up, focusing on TR progression and MV aetiology. Linear regression analysis was performed for change in TR at follow-up, using pre-determined variables and confounders.

Results

In total 204 patients without TV repair were analysed. Development of more than moderate TR after a median of 3.1 [1.6–4.6] years was rarely seen: only in 2 out of 161 patients (1.2%) with known TR grade at follow-up. Overall, median preoperative and late postoperative TR grade were equal (p = 0.116). Subanalysis showed no significant difference in MV aetiology subgroups. Preoperative TR grade and male gender were inversely correlated to change in TR. Mortality was not influenced by the 1‑year postoperative TR severity.

Conclusion

Our data showed that in a study population of patients with mild to moderate TR undergoing MV surgery without concomitant TV repair, significant late TR was rarely seen. Based on our study, it is safe to waive concomitant TV repair in this specific patient cohort.

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Netherlands Heart Journal

Het Netherlands Heart Journal wordt uitgegeven in samenwerking met de Nederlandse Vereniging voor Cardiologie en de Nederlandse Hartstichting. Het tijdschrift is Engelstalig en wordt gratis beschikbaa ...

Extra materiaal
Online Resource 1: Subcategories for the types of mitral valve etiology (figure). Online Resource 2 reflects the univariable and multivariable analysis in change in tricuspid regurgitation grade (n = 161) between baseline and most recent echocardiographic follow-up, and pre-determined variables of interest at baseline (table)
12471_2018_1159_MOESM1_ESM.docx
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