Journal List > Korean Circ J > v.35(12) > 1016067

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Kwon, Shin, Jung, Lee, Kim, Kim, Hwang, Park, Chang, Kim, Sohn, Kim, Ahn, Oh, Park, and Choi: Echocardiographic Parameters for Predicting the Outcome of Patients Undergoing Surgery for Severe Tricuspid Regurgitation
Original Article
Korean Circulation Journal

Korean Circulation Journal 2005; 35(12): 916-920.

Published online: 31 December 2005

DOI: https://doi.org/10.4070/kcj.2005.35.12.916

Echocardiographic Parameters for Predicting the Outcome of Patients Undergoing Surgery for Severe Tricuspid Regurgitation

Dong A Kwon, Dong Ho Shin, Jin Wook Jung, Seung Pyo Lee, Yoo Jung Kim, Sun Young Kim, Suk Jae Hwang, Jin Shik Park, Hyuk Jae Chang, Yong Jin Kim, Dae Won Sohn, Ki Bong Kim, Hyuk Ahn, Byung Hee Oh, Young Bae Park, Yun Shik Choi

Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.

Department of Thoracic Surgery, Seoul National University College of Medicine, Seoul, Korea.

dwsohn@snu.ac.kr

Copyright © 2005 The Korean Society of Circulation

Abstract

BACKGROUND AND OBJECTIVES: This study was performed to identify echocardiographic parameters related to postoperative clinical outcome (PCO) in patients undergoing surgery for severe tricuspid regurgitation (TR) following mitral valve surgery. The indications for surgery due to severe TR following mitral valve surgery are not well defined largely because of a lack of knowledge of the prognostic factors of PCO in these patients.
SUBJECTS AND METHODS: Eighteen patients (male/female; 2/16, mean age 58 years) with severe TR associated with prior mitral valve surgery were prospectively enrolled. Comprehensive echocardiographic examinations were performed before and 15±7 months after surgery. Favorable PCO was defined as an improvement of ≥1 in New York Heart Association (NYHA) functional class or a >25% increase in respiratory variation of IVC diameter. Non-survivors and survivors without a favorable PCO were defined as having an unfavorable PCO.
RESULTS: The operative mortality was 11% (2/18). Of the 16 survivors, nine (9/16, 56%) achieved a favorable PCO. NYHA functional class, age, left ventricular ejection fraction, right ventricular fractional area change, severity of TR and pulmonary artery pressure were not related to PCO. Only systolic tricuspid annulus velocity (ST') was found to be associated with PCO (favorable vs unfavorable PCO; 12.9±2.1cm/s vs 9.7±1.7cm/s, p<0.05). For ST' value (9.5 cm/s, the sensitivity, specificity, positive and negative predictive values for predicting an unfavorable PCO were 67%, 100%, 100% and 75%, respectively.
CONCLUSION: This study shows that ST' can predict PCO in patients undergoing surgery for severe TR following mitral valve surgery.

Keywords: Tricuspid regurgitation, Surgical outcome, Tricuspid annulus velocity

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