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Clinical outcomes of tricuspid valve repair accompanying left-sided heart disease

World Journal of Cardiology 2017年第10期9卷 787-793页

作者： Kasra Azarnoush Ahmad S Nadeemy Bruno Pereira Massoud A Leesar Céline Lambert Alaa Azhari Vedat Eljezi Nicolas Dauphin Etienne Geoffroy Lionel Camilleri INRA UMR 1019 Nutrition Humaine Department of Cardiac Surgery CHU Gabriel Montpied Kabul Medical University Heart Disease Institute Biostatistics Unit CHU Gabriel Montpied Interventional Cardiology University of Alabama

AIM To determine whether the need for additional tricuspid valve repair is an independent risk factor when surgery is required for a left-sided heart *** One hundred and eighty patients(68 ± 12 years,79 males) underwent tricuspid *** proportionalhazards regression model for multivariate analysis was performed for variables found significant in univariate *** Tricuspid regurgitation etiology was functional in 154 cases(86%),organic in 16 cases(9%),and mixed in10 cases(6%),*** mortality at 30 days was 11.7%.Mean follow-up was 51.7 mo with survival at 5 years of 73.5%.Risk factors for mortality were acute endocarditis [hazard ratio(HR) = 9.22(95%CI:2.87-29.62),P valve stenosis [HR = 2.6(1.15-5.85),P = 0.021].Significant predictive factors from univariate analyses were double-valve replacement combined with tricuspid annuloplasty [HR = 2.21(1.11-4.39),P = 0.003] and preoperatively impaired ejection fraction [HR = 1.98(1.04-3.92),P = 0.044].However,successful mitral valve repair showed a protective effect [HR = 0.32(0.10-0.98),P = 0.046].Additionally,in instances where tricuspid regurgitation required the need for concomitant tricuspid valve repair,mortality predictor scores such as Euroscore 2 could be shortened to a simple Euroscore-tricuspid comprised of only 7 *** explanation may lie in the fact that significant tricuspid regurgitation following leftsided heart disease represents an independent risk factor encompassing several other factors such as pulmonary arterial hypertension and *** Tricuspid annuloplasty should be used more often as a concomitant procedure in the presence of relevant tricuspid regurgitation,although it usually reveals an overly delayed correction of a left-sided heart disease.

关键词： Tricuspid regurgitation Patient outcome assessment Valvular annuloplasty Infective endocarditis mitral valve annuloplasty

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