Circulation Journal
Online ISSN : 1347-4820
Print ISSN : 1346-9843
ISSN-L : 1346-9843
Cardiovascular Surgery
Persistent Tricuspid Regurgitation After Tricuspid Annuloplasty During Redo Valve Surgery Affects Late Survival and Valve-Related Events
Naoto FukunagaYukikatsu OkadaYasunobu KonishiTakashi MurashitaTadaaki Koyama
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2014 Volume 78 Issue 11 Pages 2696-2703

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Abstract

Background:Long-term survival and incidence of late tricuspid regurgitation (TR) were studied in patients who underwent tricuspid annuloplasty (TAP) during redo valve surgery.Methods and Results:We retrospectively analyzed 125 patients (mean age, 64.5±10.4 years) who underwent TAP using suture (n=54, group S) or ring (n=71, group R) implantation during redo surgery in a 20-year period. There was a significant difference in prevalence of preoperative atrial fibrillation (P=0.0199). More group S patients were in New York Heart Association functional class III or IV than group R patients (P=0.0066). Mean follow-up was 6.6±5.3 years. Mortality rate for group S was 9.3%, and for group R, 7.0% (P=0.6508). Survival at 5 and 10 years was 72.2±6.6% vs. 88.1±4.0%, and 66.4±7.3% vs. 61.0±7.2%, respectively (log-rank, P=0.7235). Less than moderate TR (hazard ratio [HR], 0.113; P=0.0198) before discharge was a predictor of late survival. There was no statistically significant difference in freedom from valve-related events (log-rank, P=0.5196). A predictor of freedom from valve-related events was less than moderate TR before discharge (HR 0.428; P=0.0100). It was also a positive predictor of freedom from late TR more than mild (HR 0.070; P<0.0001).Conclusions:Less than moderate TR before discharge after TAP during redo valve surgery was an independent risk factor for better long-term outcome. (Circ J 2014; 78: 2696–2703)

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© 2014 THE JAPANESE CIRCULATION SOCIETY
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