초록접수 현황
| 17F-204 | 구연 발표 |
Progression of Functional Tricuspid Regurgitation and Impact of Concomitant Tricuspid Annuloplasty at the Time of Mitral Valve Repair for Degenerative Mitral Regurgitation
Jung-Hwan Kim, Seung Hyun Lee, Hyun-Chel Joo, Young-Nam Youn, Kyung-Jong Yoo, Byung-Chul Chang, Sak Lee
Department of Cardiovascular Surgery, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
Purpose : To study the progression of pre-operative functional tricuspid regurgitation (TR) and the impact of concomitant tricuspid annuloplasty (TAP) at time of mitral repair for degenerative mitral regurgitation (MR).
Methods : From January 1990 to December 2015, 792 patients underwent mitral repair for degenerative MR. Pre- and post-operative TR was identified in 768 patients and enrolled in this study. The mean follow-up duration was 9.5±5.7 years and the mean echocardiographic follow-up duration was 5.5±5.3 years.
Results : Pre-operative mild TR was present in 292 (38.0%) patients and atrial fibrillation was present in 209 (27.2%). Concomitant TAP was performed in 119 (15.5%) patients and maze operation was performed in 65 (8.5%) patients. Freedom from newly onset moderate-to-severe TR (≥2) at 10 years in patients without pre-operative TR was 95.7±1.6%, and freedom from post-operative severe TR (≥3) in patients with pre-operative mild-to-moderate TR was 92.7±3.3%. In patients with pre-operative TR, concomitant TAP could not affect to the post-operative severe TR (HR=0.523 [0.229-1.194], p=0.124) and late death (HR=0.687 [0.418-1.128], p=0.138). Pre-operative atrial fibrillation was a strong risk factor of overall death (HR=2.014 [1.331-3.047], p=0.001), post-operative severe TR (HR=4.097 [1.333-12.597], p=0.014), and tricuspid re-operation (HR=17.517 [2.336-131.347], p=0.005). And recurrent MR (≥3) was also risk factor of post-operative severe TR (HR=2.966 [1.004-8.759], p=0.049), and tricuspid re-operation (HR=27.111 [4.304-170.786], p<0.001).
Conclusion : Progression of TR after mitral repair for degenerative MR was uncommon. Precise repair of MR is important for TR progression and maze operation for atrial fibrillation could help reduce the TR progression.
Methods : From January 1990 to December 2015, 792 patients underwent mitral repair for degenerative MR. Pre- and post-operative TR was identified in 768 patients and enrolled in this study. The mean follow-up duration was 9.5±5.7 years and the mean echocardiographic follow-up duration was 5.5±5.3 years.
Results : Pre-operative mild TR was present in 292 (38.0%) patients and atrial fibrillation was present in 209 (27.2%). Concomitant TAP was performed in 119 (15.5%) patients and maze operation was performed in 65 (8.5%) patients. Freedom from newly onset moderate-to-severe TR (≥2) at 10 years in patients without pre-operative TR was 95.7±1.6%, and freedom from post-operative severe TR (≥3) in patients with pre-operative mild-to-moderate TR was 92.7±3.3%. In patients with pre-operative TR, concomitant TAP could not affect to the post-operative severe TR (HR=0.523 [0.229-1.194], p=0.124) and late death (HR=0.687 [0.418-1.128], p=0.138). Pre-operative atrial fibrillation was a strong risk factor of overall death (HR=2.014 [1.331-3.047], p=0.001), post-operative severe TR (HR=4.097 [1.333-12.597], p=0.014), and tricuspid re-operation (HR=17.517 [2.336-131.347], p=0.005). And recurrent MR (≥3) was also risk factor of post-operative severe TR (HR=2.966 [1.004-8.759], p=0.049), and tricuspid re-operation (HR=27.111 [4.304-170.786], p<0.001).
Conclusion : Progression of TR after mitral repair for degenerative MR was uncommon. Precise repair of MR is important for TR progression and maze operation for atrial fibrillation could help reduce the TR progression.
책임저자: Sak Lee
Department of Cardiovascular Surgery, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
발표자: Jung-Hwan Kim, E-mail : jhkim0907@yuhs.ac