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Tricuspid Valve Tethering Predicts Residual Tricuspid Regurgitation After Tricuspid Annuloplasty
Abstract
Background— Tricuspid valve (TV) annuloplasty is recommended for functional tricuspid regurgitation (TR), which is caused by TV annulus dilatation and tethering of the leaflets. However, the impact of TV deformations on the outcome of TV annuloplasty remains unknown. The goal of this study was to investigate the relationship between preoperative TV deformation and residual TR after TV annuloplasty. Methods and Results— Two hundred sixteen patients with functional TR had 2D echocardiography before and after TV annuloplasty. Right ventricular fractional area change and left ventricular ejection fraction were determined with the apical views. Minimal TV annulus diameter was determined by frame-by-frame analysis. The distance of TV tethering was measured from the annulus plane to the coaptation point and tethering area by tracing the leaflets from the annulus plane. TR severity was determined by the ratio of the maximal jet area to the corresponding right atrial area. The severity of residual TR was associated with age, right and left ventricular dysfunction, tethering distance and area, and severity of preoperative TR (all P <0.05). TV annular dimension was not associated with outcome of TV annuloplasty. Multivariate analysis revealed that age, tethering distance, and severity of preoperative TR (all P <0.001) were independent parameters predicting residual TR. The sensitivity and specificity in predicting residual TR after surgery were 86% and 80% for tethering distances >0.76 cm and 82% and 84% for tethering areas >1.63 cm 2 , respectively. Conclusions— Severe TV tethering predicted residual TR after TV annuloplasty, whereas preoperative TV annular dimension was not associated with outcome of TV annuloplasty.
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Cites
STATISTICAL METHODS FOR ASSESSING AGREEMENT BETWEEN TWO METHODS OF CLINICAL MEASUREMENT
Martin Bland, J., & Altman, D. (1986) · The Lancet · doi:10.1016/s0140-6736(86)90837-8 · Cited by 47,965
Cited by
The Tricuspid Valve: Current Perspective and Evolving Management of Tricuspid Regurgitation
Rogers, J. H., & Bolling, S. F. (2009) · Circulation · doi:10.1161/circulationaha.108.842773 · Cited by 389
Transcatheter Treatment of Severe Tricuspid Regurgitation With the Edge-to-Edge MitraClip Technique
Nickenig, G., Kowalski, M., Hausleiter, J., Braun, D., Schofer, J., Yzeiraj, E., Rudolph, V., Friedrichs, K., Maisano, F., Taramasso, M., et al. (2017) · Circulation · doi:10.1161/circulationaha.116.024848 · Cited by 365
Valente, A. M., Cook, S., Festa, P., Ko, H. H., Krishnamurthy, R., Taylor, A. M., Warnes, C. A., Kreutzer, J., & Geva, T. (2014) · Journal of the American Society of Echocardiography · doi:10.1016/j.echo.2013.11.009 · Cited by 317
Metadata
- Authors
- Fukuda, S., Song, J.-M., Gillinov, A. M., McCarthy, P. M., Daimon, M., Kongsaerepong, V., Thomas, J. D., & Shiota, T.
- Venue
- Circulation
- Published
- 2005-03
- Volume
- 111
- Issue
- 8
- Pages
- 975-979
- ISSN
- 0009-7322 (ISSN-L)
- 1524-4539
- OpenAlex
- W1966383783
- Cited by
- 333
- References
- 1
- FWCI
- 8.27
- Type
- journal article
- Language
- en
- Open access
- closed
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- Fukuda, S., Song, J.-M., Gillinov, A. M., McCarthy, P. M., Daimon, M., Kongsaerepong, V., Thomas, J. D., & Shiota, T. (2005). Tricuspid Valve Tethering Predicts Residual Tricuspid Regurgitation After Tricuspid Annuloplasty. Circulation. https://doi.org/10.1161/01.cir.0000156449.49998.51
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