Original article: cardiovascularPredictors of residual tricuspid regurgitation after mitral valve surgery
Section snippets
Material and methods
Between March 1988 and September 2001, 274 patients had mitral valve surgery at our institution. Of these patients, 175 consecutive patients underwent mitral valve surgery without tricuspid valve surgery, and their records were retrospectively reviewed. Patients with concomitant procedures, such as coronary artery bypass grafting or aortic valve replacement, were excluded form this study. All patients had complete physical examinations preoperatively, with echocardiographic studies and cardiac
Results
There was one operative death. A total of 174 patients were included in this study. MVR was undergone in 76 patients, (44%) and mitral valve repair was 92 patients (56%). MVR was performed using a St. Jude Medical prosthesis (St. Paul, MN) in all patients. The mean follow-up was 8.2 ± 3.6 years (range 1.0 to 14.5 years) after surgery. There were 14 late deaths (8%). The cause of death was sudden death in 2 patients, cardiac failure in 1 patient, brain infarction or bleeding in 3 patients,
Comment
The surgical management of secondary TR due to left-sided heart valve lesions remains controversial. In this series, significant TR was present in 16% of patients late after MVR without tricuspid valve surgery.
Several mechanisms may be responsible for the high prevalence of late TR. First, persistent pressure overload due to pulmonary hypertension may contribute to TR progression [8]. However, a recent report demonstrated that preoperative pulmonary hypertension was not a risk factor for
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