초록접수 현황
| 17F-274 | 구연 미채택시 포럼 발표 |
The Optimal Criteria of Tricuspid Annuloplasty for the Patients with Less than Moderate Functional TR
Jae Woong Choi, Ho Young Hwang, Kyung Hwan Kim
Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
Purpose : We evaluated the risk factor for progression of tricuspid regurgitation (TR) and suggested the optimal criteria of a tricuspid annuloplasty in patients with less than moderate functional TR.
Methods : From August 2007 to December 2014, 227 patients (56.4 ± 12.1 years old) with less than moderate TR underwent mitral valve surgery for rheumatic or degenerative mitral valve disease without tricuspid valve procedure. The preoperative TR was graded from 1 to 3; 1=trivial, 2=mild, and 3=mild to moderate. TV annulus diameters were measured in the transthoracic apical 4-chamber view in late diastole. The clinical follow-up durations was 57.5 ± 31.2months.
Results : Nine (3.9%) patients developed moderate or greater TR during follow-up (severe: 2 patients, moderate: 7 patients). TV annular size and preoperative atrial fibrillation were associated with development of TR ≥moderate in multivariable analysis (p = 0.007 and p = 0.010, respectively). TV annulus sizes of all patients who developed TR ≥ moderate were lower than 40mm of current recommendation. The TV annular size of 29.6mm was a cut-off value predicting the recurrent of TR ≥ moderate.
Conclusion : Although the follow-up duration was short, the progression of TR was not infrequent in patients with untreated less than moderate TR. TV annular size was a risk factor for development of TR ≥moderate and the optimal cut-off value for predicting TR ≥moderate was 26.9mm. Aggressive approach for TV annuloplasty would be helpful to prevent the progression of less than moderate FTR.
Methods : From August 2007 to December 2014, 227 patients (56.4 ± 12.1 years old) with less than moderate TR underwent mitral valve surgery for rheumatic or degenerative mitral valve disease without tricuspid valve procedure. The preoperative TR was graded from 1 to 3; 1=trivial, 2=mild, and 3=mild to moderate. TV annulus diameters were measured in the transthoracic apical 4-chamber view in late diastole. The clinical follow-up durations was 57.5 ± 31.2months.
Results : Nine (3.9%) patients developed moderate or greater TR during follow-up (severe: 2 patients, moderate: 7 patients). TV annular size and preoperative atrial fibrillation were associated with development of TR ≥moderate in multivariable analysis (p = 0.007 and p = 0.010, respectively). TV annulus sizes of all patients who developed TR ≥ moderate were lower than 40mm of current recommendation. The TV annular size of 29.6mm was a cut-off value predicting the recurrent of TR ≥ moderate.
Conclusion : Although the follow-up duration was short, the progression of TR was not infrequent in patients with untreated less than moderate TR. TV annular size was a risk factor for development of TR ≥moderate and the optimal cut-off value for predicting TR ≥moderate was 26.9mm. Aggressive approach for TV annuloplasty would be helpful to prevent the progression of less than moderate FTR.
책임저자: Kyung Hwan Kim
Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
발표자: Jae Woong Choi, E-mail : woong3537@hanamail.net