Clinical Outcomes After Tricuspid Valve Annuloplasty in Addition to Mitral Valve Surgery
Article first published online: 1 OCT 2012
© 2012 Wiley Periodicals, Inc.
Congestive Heart Failure
Volume 19, Issue 2, pages 70–76, March/April 2013
How to Cite
Koppers, G., Verhaert, D., Verbrugge, F. H., Reyskens, R., Gutermann, H., Van Kerrebroeck, C., Vandervoort, P., Tang, W. H. W., Dion, R. and Mullens, W. (2013), Clinical Outcomes After Tricuspid Valve Annuloplasty in Addition to Mitral Valve Surgery. Congestive Heart Failure, 19: 70–76. doi: 10.1111/chf.12004
- Issue published online: 1 APR 2013
- Article first published online: 1 OCT 2012
- Manuscript received: March 28, 2012; revised: July 27, 2012; accepted: August 13, 2012
©2012 Wiley Periodicals, inc.
Current guidelines recommend tricuspid valve annuloplasty (TVP) together with mitral valve surgery in cases of tricuspid annulus dilation (≥40 mm) or functional tricuspid valve regurgitation >2/4. Baseline clinical and echocardiographic data of patients undergoing mitral valve surgery in a single tertiary care hospital between 2007 and 2010 were analyzed. Mortality and heart failure hospitalization data were collected and groups with or without TVP were compared. Patients with TVP (n=89) had similar baseline characteristics compared with patients without (n=86), except for lower right ventricular fractional area change and more concomitant aortic valve surgery. Mortality was higher in the TVP group at 30 days (14% vs 5%; P=.04), but the difference was no longer significant at the end of follow-up. More patients were hospitalized for heart failure in the TVP group (31% vs 17%; hazard ratio, 2.1; 95% confidence interval, 1.1–4.0; P=.05). Right ventricular sphericity index was the only preoperative parameter predicting death or heart failure hospitalizations. In conclusion, patients undergoing TVP in addition to mitral valve surgery are at high risk for early death or subsequent heart failure hospitalizations, which might be partly explained by more complex heart disease. The extent of preoperative right ventricular remodeling may be predictive of adverse outcomes.