Long-term outcomes of patients with mitral replacement and suture tricuspid annuloplasty_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

 XIAO Xijun ¹ , DENG Yundan ² , QIAN Yongjun ¹ , LIN Fushun ³ , LUO Yi ¹ , XU Chao ¹

1. Division of Cardiovascular Surgery, West China Hospital, Sichuan University, Chengdu, 610041, P.R.China;
2. Department of Thoracic and Cardiovascular Surgery, The First Affiliated Hospital of Lanzhou University, Lanzhou, 730000, P.R.China;
3. Department of Cardiovascular Surgery, Qilu Hospital of Shandong University, Qilu, 266000, Shandong, P.R.China ;

Corresponding author：

XIAO Xijun, Email: xijunxiao@hotmail.com

Keywords：

Mitral valve replacement; suture tricuspid annuloplasty; long-term observation

DOI：

10.7507/1007-4848.201612048

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To evaluate long-term clinical results in patients who underwent mitral valve replacement and suture tricuspid annuloplasty. Methods We included 401 patients who underwent mitral valve replacement and suture tricuspid annuloplasty in our hospital between January 2006 and March 2011. There were 309 females and 92 males at age of 17-71 (46.2±12.0) years. All patients were investigated by echocardiography at postoperative 5 years. The tricuspid valve procedures consisted of bicuspidization, modified Kay annuloplasty and leaflet repair according to the actual conditions. Results The patients were followed up for 5–10 (7.4±1.4) years. As compared with preoperation, the right atrium (RA, 7.6±13.0 mm vs. 49.3±13.2 mm), right ventrium (RV, 23.2±4.7 mm vs. 22.0±3.6 mm), left atrium (LA, 59.7±19.0 mm vs. 53.6±14.7 mm, left ventrium (LV, 49.3±8.6 mm vs. 47.7±6.2 mm), tricuspid of end-distolic diameters (TEDD, 35.9±5.7 mm vs. 32.8±5.9 mm) and tricuspid of end-systolic diameters (TESD, 9.4±5.7 mm vs. 26.5±4.9 mm) of patients decreased significantly at postoperation (P<0.01). As compared with preoperation, left ventricular ejection fraction (LVEF, 60.3%±8.9% vs. 61.7%±8.3%) and left ventricular fractional shortening (LVFS, 32.6%±6.3% vs. 33.8%±5.5%) raised significantly at postoperation (P<0.01). As compared with preoperation, the constituent rate of tricuspid regurgitation (TR) improved significantly at postoperation (P<0.01). Conclusion Tricuspid annuloplasty adopting TEDD as a surgical indication is reasonable for patients with mitral diseases. Combined and individualized suture tricuspid annuloplasty can obtain better long-term results. It is needed to order aggressive diuretics treatment for patients with postoperative TR.

Citation： XIAO Xijun, DENG Yundan, QIAN Yongjun, LIN Fushun, LUO Yi, XU Chao. Long-term outcomes of patients with mitral replacement and suture tricuspid annuloplasty. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2017, 24(9): 692-695. doi: 10.7507/1007-4848.201612048 Copy

1.	Kuwaki K, Morishita K, Tsukamoto M, et al. Tricuspid valve surgery for functional tricuspid valve regurgitation associated with left-sided valvular disease. Eur J Cardiothorac Surg, 2001, 20(2): 577-582.
2.	Navia JL, Nowicki ER, Blackstone EH, et al. Surgical management of secondary tricuspid valve regurgitation: Annulus, commissure, or leaflet procedure? J Thorac Cardiovasc Surg, 2010, 139(6):1473-1482.
3.	肖锡俊, 袁宏声, 唐红, 等. 二尖瓣置换术后三尖瓣反流的逆转、残留或加重.中国胸心血管外科临床杂志, 2006, 13(5): 307-310.
4.	Chikwe J, Anyanwu AC. Surgical strategies for functional tricuspid regurgitation. Semi Thorac Cardivasc Surg, 2010, 22(1): 90-96.
5.	Bianchi G, Solinas M, Bevilaccqua S, et al. Which patient undergoing mitral valve surgery should also have the tricuspid repair? Inter Cardiovasc Thorac Surg, 2009, 9(4): 1009-1020.
6.	朱鹏, 肖锡俊, 唐红, 等. 以三尖瓣瓣环径作为三尖瓣成形手术指征的初步临床观察. 中国胸心血管外科临床杂志, 2008, 15(4): 245-248.
7.	肖锡俊, 蒋露, 李永波, 等. 联合二瓣化和改良 Kay 成形术处理左心瓣膜手术患者三尖瓣瓣环扩张的初步疗效观察. 中国胸心血管外科临床杂志, 2012, 19(5): 516-519.
8.	Colombo T, Russo C, Ciliberto GR, et al. Tricuspid regurgitation secondary to mitral valve disease: tricuspid annulus function as guide to tricuspic valve repair. Cardiovasc Surg, 2001, 9(4): 369-377.
9.	Bertrand PB, Koppers G, Herbrugge FH, et al. Tricuspid annuloplasty concomitant with mitral valve surgery: Effects on right ventricular remodeling. J Thorac Cardiovasc Surg, 2014, 147(4): 1256-1264.
10.	Tager R, Skudicky D, Mueller U, et al. Long-term follow-up of rheumatic patients undergoing left-sided valve replacement with tricuspid, annuloplasty-validity of preoperative echocardiographic criteria in the decision to perform tricuspid annuloplasty. Am J Cardiol, 1998, 81(8): 1013-1016.
11.	Nishimura RA, Otto CM, Bonow RO, et al. 2014 AHA/ACC Guideline for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation, 2014, 129(2): e521-643.
12.	Vahanian A, Alfieri O, Andreotti F, et al. Guidelines on the management of valvular heart disease( version 2012): the Joint Task Force on the Management of Valvular Heart Disease of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS). Eur J Cardiothorac Surg, 2012, 41(1): S1-S44.
13.	McCarthy PM, Sales VL. Evolving indications for tricuspid valve surgery. Curr Treat Options Cardiovasc Med, 2010, 12(6): 587-597.
14.	Dion RA. Is the air in Toronto, Rochester, and Cleveland different from that in London, Monaco, Leiden, Genk, Milan, and New York? J Thorac Cardiovasc Surg, 2015, 150(5): 1040-1041.
15.	Ghanta RK, Chen R, Narayanasamy N, et al. Suture bicuspidization of the tricuspid valve versus ring annuloplasty for repair of functional tricuspid regurgitation: Midterm results of 237 consecutive patients. J Thorac Cardiovasc Surg, 2007, 133(1):117-126.
16.	Duran CMG. Tricuspid valve surgery revisited. J Card Surg, 1994(Supp1): 242-247.
17.	Dreyfus GD, Corbi PJ, John Chan KM, et al. Secondary tricuspid regurgitation or dilatation: Which should be the criteria for surgical repair? Ann Thorac Surg, 2005, 79(1): 127-132.
18.	李永波, 唐红, 梁春水, 等. 三尖瓣瓣环扩张伴轻度反流的二尖瓣置换手术患者同期行三尖瓣成形术的随机对照试验. 中国胸心血管外科临床杂志, 2015, 22(6): 518-525.
19.	邓云丹, 李永波, 钱永军, 等. 二尖瓣置换手术患者同期行三尖瓣成形术后两年超声心动图评价的随机对照试验. 中国胸心血管临床杂志, 2016, 23(7): 658-665.
20.	Rogers JH, Boling SF. Valve repair for functional tricuspid valve regurgitation: Anatomical and surgical considerations. Semi Thorac Cardiovas Surg, 2010, 22(1): 84-89.
21.	Castedo E, Canas A, Cabo RA, et al. Edge-to-edge tricuspid repair for redeveloped valve incompetence after DeVega’s annuloplasty. Ann Thoracs Surg, 2003, 75(3): 605-606.
22.	Bernal JM, Gutierrez-Morlote J, Llorca J, et al. Tricuspid valve repair: An old disease, a modern experience. Ann Thorac Surg, 2004, 78(4): 2069-2075.
23.	Naqshband MS, Abid AR, Akhtar RP, et al. Functional tricuspid regurgitation in rheumatic heart disease: Surgical options. Ann Thorac Cardiovasc Surg, 2010, 16(3): 417-425.
24.	Antunes MJ, Barlow JB. Management of tricuspid valve regurgitation. Heart, 2007, 93(2): 271-276.

1. Kuwaki K, Morishita K, Tsukamoto M, et al. Tricuspid valve surgery for functional tricuspid valve regurgitation associated with left-sided valvular disease. Eur J Cardiothorac Surg, 2001, 20(2): 577-582.
2. Navia JL, Nowicki ER, Blackstone EH, et al. Surgical management of secondary tricuspid valve regurgitation: Annulus, commissure, or leaflet procedure? J Thorac Cardiovasc Surg, 2010, 139(6):1473-1482.
3. 肖锡俊, 袁宏声, 唐红, 等. 二尖瓣置换术后三尖瓣反流的逆转、残留或加重.中国胸心血管外科临床杂志, 2006, 13(5): 307-310.
4. Chikwe J, Anyanwu AC. Surgical strategies for functional tricuspid regurgitation. Semi Thorac Cardivasc Surg, 2010, 22(1): 90-96.
5. Bianchi G, Solinas M, Bevilaccqua S, et al. Which patient undergoing mitral valve surgery should also have the tricuspid repair? Inter Cardiovasc Thorac Surg, 2009, 9(4): 1009-1020.
6. 朱鹏, 肖锡俊, 唐红, 等. 以三尖瓣瓣环径作为三尖瓣成形手术指征的初步临床观察. 中国胸心血管外科临床杂志, 2008, 15(4): 245-248.
7. 肖锡俊, 蒋露, 李永波, 等. 联合二瓣化和改良 Kay 成形术处理左心瓣膜手术患者三尖瓣瓣环扩张的初步疗效观察. 中国胸心血管外科临床杂志, 2012, 19(5): 516-519.
8. Colombo T, Russo C, Ciliberto GR, et al. Tricuspid regurgitation secondary to mitral valve disease: tricuspid annulus function as guide to tricuspic valve repair. Cardiovasc Surg, 2001, 9(4): 369-377.
9. Bertrand PB, Koppers G, Herbrugge FH, et al. Tricuspid annuloplasty concomitant with mitral valve surgery: Effects on right ventricular remodeling. J Thorac Cardiovasc Surg, 2014, 147(4): 1256-1264.
10. Tager R, Skudicky D, Mueller U, et al. Long-term follow-up of rheumatic patients undergoing left-sided valve replacement with tricuspid, annuloplasty-validity of preoperative echocardiographic criteria in the decision to perform tricuspid annuloplasty. Am J Cardiol, 1998, 81(8): 1013-1016.
11. Nishimura RA, Otto CM, Bonow RO, et al. 2014 AHA/ACC Guideline for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation, 2014, 129(2): e521-643.
12. Vahanian A, Alfieri O, Andreotti F, et al. Guidelines on the management of valvular heart disease( version 2012): the Joint Task Force on the Management of Valvular Heart Disease of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS). Eur J Cardiothorac Surg, 2012, 41(1): S1-S44.
13. McCarthy PM, Sales VL. Evolving indications for tricuspid valve surgery. Curr Treat Options Cardiovasc Med, 2010, 12(6): 587-597.
14. Dion RA. Is the air in Toronto, Rochester, and Cleveland different from that in London, Monaco, Leiden, Genk, Milan, and New York? J Thorac Cardiovasc Surg, 2015, 150(5): 1040-1041.
15. Ghanta RK, Chen R, Narayanasamy N, et al. Suture bicuspidization of the tricuspid valve versus ring annuloplasty for repair of functional tricuspid regurgitation: Midterm results of 237 consecutive patients. J Thorac Cardiovasc Surg, 2007, 133(1):117-126.
16. Duran CMG. Tricuspid valve surgery revisited. J Card Surg, 1994(Supp1): 242-247.
17. Dreyfus GD, Corbi PJ, John Chan KM, et al. Secondary tricuspid regurgitation or dilatation: Which should be the criteria for surgical repair? Ann Thorac Surg, 2005, 79(1): 127-132.
18. 李永波, 唐红, 梁春水, 等. 三尖瓣瓣环扩张伴轻度反流的二尖瓣置换手术患者同期行三尖瓣成形术的随机对照试验. 中国胸心血管外科临床杂志, 2015, 22(6): 518-525.
19. 邓云丹, 李永波, 钱永军, 等. 二尖瓣置换手术患者同期行三尖瓣成形术后两年超声心动图评价的随机对照试验. 中国胸心血管临床杂志, 2016, 23(7): 658-665.
20. Rogers JH, Boling SF. Valve repair for functional tricuspid valve regurgitation: Anatomical and surgical considerations. Semi Thorac Cardiovas Surg, 2010, 22(1): 84-89.
21. Castedo E, Canas A, Cabo RA, et al. Edge-to-edge tricuspid repair for redeveloped valve incompetence after DeVega’s annuloplasty. Ann Thoracs Surg, 2003, 75(3): 605-606.
22. Bernal JM, Gutierrez-Morlote J, Llorca J, et al. Tricuspid valve repair: An old disease, a modern experience. Ann Thorac Surg, 2004, 78(4): 2069-2075.
23. Naqshband MS, Abid AR, Akhtar RP, et al. Functional tricuspid regurgitation in rheumatic heart disease: Surgical options. Ann Thorac Cardiovasc Surg, 2010, 16(3): 417-425.
24. Antunes MJ, Barlow JB. Management of tricuspid valve regurgitation. Heart, 2007, 93(2): 271-276.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Long-term outcomes of patients with mitral replacement and suture tricuspid annuloplasty

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content