Progression of Isolated Tricuspid Regurgitation Late After Left-Sided Valve Surgery – Clinical Features and Mechanisms –

Chisato Izumi; Makoto Miyake; Shuichi Takahashi; Hayato Matsutani; Sumiyo Hashiwada; Kazuyo Kuwano; Hidetaka Hayashi; Seiko Nakajima; Masataka Nishiga; Koji Hanazawa; Jiro Sakamoto; Hirokazu Kondo; Toshihiro Tamura; Kazuaki Kaitani; Kazuo Yamanaka; Yoshihisa Nakagawa

doi:10.1253/circj.CJ-11-0718

Valvular Heart Disease

Progression of Isolated Tricuspid Regurgitation Late After Left-Sided Valve Surgery

– Clinical Features and Mechanisms –

Chisato Izumi, Makoto Miyake, Shuichi Takahashi, Hayato Matsutani, Sumiyo Hashiwada, Kazuyo Kuwano, Hidetaka Hayashi, Seiko Nakajima, Masataka Nishiga, Koji Hanazawa, Jiro Sakamoto, Hirokazu Kondo, Toshihiro Tamura, Kazuaki Kaitani, Kazuo Yamanaka, Yoshihisa Nakagawa

Author information

Chisato Izumi
Department of Cardiology, Tenri Hospital
Makoto Miyake
Department of Cardiology, Tenri Hospital
Shuichi Takahashi
Department of Clinical Pathology, Tenri Hospital
Hayato Matsutani
Department of Clinical Pathology, Tenri Hospital
Sumiyo Hashiwada
Department of Clinical Pathology, Tenri Hospital
Kazuyo Kuwano
Department of Clinical Pathology, Tenri Hospital
Hidetaka Hayashi
Department of Clinical Pathology, Tenri Hospital
Seiko Nakajima
Department of Cardiology, Tenri Hospital
Masataka Nishiga
Department of Cardiology, Tenri Hospital
Koji Hanazawa
Department of Cardiology, Tenri Hospital
Jiro Sakamoto
Department of Cardiology, Tenri Hospital
Hirokazu Kondo
Department of Cardiology, Tenri Hospital
Toshihiro Tamura
Department of Cardiology, Tenri Hospital
Kazuaki Kaitani
Department of Cardiology, Tenri Hospital
Kazuo Yamanaka
Department of Cardiovascular Surgery, Tenri Hospital
Yoshihisa Nakagawa
Department of Cardiology, Tenri Hospital

Keywords: Echocardiography, Surgery, Tricuspid regurgitation, Valvular disease

JOURNAL FREE ACCESS

2011 Volume 75 Issue 12 Pages 2902-2907

DOI https://doi.org/10.1253/circj.CJ-11-0718

View "Advance Publication" version (September 23, 2011).

Details

Abstract

Background: Severe tricuspid regurgitation (TR) sometimes develops late after left-sided valve surgery without left heart failure, pulmonary hypertension or rheumatic tricuspid valve. The purpose of the present study was to investigate clinical characteristics and mechanisms of severe isolated TR late after left-sided valve surgery. Methods and Results: A total of 372 consecutive patients who underwent left-sided valve surgery between 1990 and 2003 and who were followed up with echocardiography for at least 5 years, were retrospectively investigated. The mean follow-up period was 9.4 years. Clinical background, preoperative and postoperative echocardiographic parameters were evaluated. Among the 372 patients, severe isolated TR was detected in 23 patients, which developed at a mean of 8.6 years after surgery. Twenty-two of 23 patients had undergone mitral valve surgery. Multivariate logistic regression analysis identified the presence of preoperative atrial fibrillation and preoperative ejection fraction as independent determinants for the development of severe isolated TR. In patients with severe isolated TR, the tricuspid annular diameter and the right atrial area were already enlarged early after surgery and both of these increased prior to TR progression. Conclusions: Severe isolated TR developing late after mitral valve surgery is not uncommon, thus it is important to recognize this disease entity. Annular dilatation was the main cause of isolated TR and serial echocardiographic data are important to detect progression of isolated TR and to assess its mechanisms. (Circ J 2011; 75: 2902-2907)

Corresponding author

Register with J-STAGE for free!