S-Space College of Medicine/School of Medicine (의과대학/대학원) Thoracic Surgery (흉부외과학전공) Journal Papers (저널논문_흉부외과학전공)
Development of tricuspid regurgitation late after left-sided valve surgery: a single-center experience with long-term echocardiographic examinations
- Issue Date
- Am Heart J. 2008 Apr;155(4):732-7. Epub 2008 Feb 21.
- Adolescent ; Adult ; Aged ; Aged, 80 and over ; Aortic Valve/surgery ; Atrial Fibrillation/complications ; Disease-Free Survival ; Echocardiography ; Female ; Female ; Heart Valve Diseases/*surgery ; Humans ; Incidence ; Logistic Models ; Male ; Middle Aged ; Mitral Valve/surgery ; Multivariate Analysis ; Preoperative Care ; Risk Factors ; Stroke Volume ; Time Factors ; Tricuspid Valve Insufficiency/epidemiology/*etiology ; Postoperative Complications/epidemiology
- OBJECTIVES: This study sought to investigate the incidence and identify the predictors of significant tricuspid regurgitation (TR) development long after left-sided valve surgery. METHODS: Of 615 patients who underwent surgery for left-sided valve disease between 1992 and 1995, 335 patients without significant TR who completed at least 5 years of clinical and echocardiographic follow-up were enrolled. Late significant TR development was assessed by echocardiography with a mean follow-up duration of 11.6 +/- 2.1 years. RESULTS: Significant late TR was found in 90 patients (26.9%). Patients with late TR showed an advanced age (47.6 +/- 13.4 vs 44.3 +/- 13.2 years, P = .04), a higher prevalence of preoperative atrial fibrillation (83.3 vs 46.5%, P < .001), a greater left atrial dimension (56.9 +/- 13.2 vs 52.4 +/- 11.5 mm, P = .006), and a higher prevalence of prior valve surgery (40.0 vs 25.3%, P = .01). In addition, late TR occurred more frequently in patients who had undergone mitral valve surgery than in those who did not (93.3 vs 72.2%, P < .001). However, multivariate analysis showed that the presence of preoperative atrial fibrillation (odds ratio 5.37; 95% CI 2.71-10.65; P < .001) was the only independent factor of late TR development. Patients who developed late TR had a lower event-free survival rate than those who did not (P = .03). CONCLUSIONS: The development of significant TR long after left-sided valve surgery is not uncommon with an estimated incidence of 27% and is closely associated with a poor prognosis. The presence of preoperative atrial fibrillation was identified as the only independent predictor of the development of late TR.
- 1097-6744 (Electronic)