초록접수 현황
| 14F-199 | 구연 발표 |
The Fate of Tricuspid Regurgitation in the Patients Undergoing Pulmonary Valve Replacement after Repair of Tetralogy of Fallot
Yu Rim Shin, Hong Ju Shin, Young-Hwan Park, Han Ki Park
Department of Thoracic and Cardiovascular Surgery, Severance Cardiovascular Hospital, Yonsei University College of Medicine
Background : It is not uncommon to find significant tricuspid regurgitation (TR) in the patients undergoing pulmonary valve replacement (PVR) after repair of tetralogy of Fallot. The purpose of this study is to assess the prevalence of the TR and its postoperative course.
Methods : From June, 2001 to December, 2014, a total of 172 patients underwent surgical PVR. The medical records were retrospectively reviewed.
Results : Among 165 patients whose preoperative echocardiography data was available, 57 (34.5 %) patients showed TR of more than moderate. These patients were older than the patients without significant TR (25.1 ± 12.3 versus 19.5 ± 10.1 years, p < 0.01), and they had larger right ventricular end-diastolic dimension (54.3 ± 10.3 versus 48.0 ± 7.4 mm, p < 0.01) and lower left ventricular ejection fraction (LVEF, 55.6 ±10.8 versus 60.1 ± 7.5 %, p < 0.01). The preoperative arrhythmia was more prevalent in the patients with significant TR. In 39 patients with significant TR who did not undergo concomitant tricuspid valve surgery, the degree of TR improved in 16 patients (41 %, group 1), while the rest of the patients had similar or worsened TR (59 %, group 2). In group 2, the patients had larger tricuspid annulus (33.5 ± 5.6 versus 29.5 ± 8.7 mm, p = 0.04), low LVEF (56.9 ± 10.2 versus 61.2 ± 6.6%, p = 0.04), and larger right ventricular end-diastolic volume (RVEDV, 307.1 ± 52.9 versus 278.6 ± 48.7 ml, p = 0.04). In the univariate analysis, these variables were associated with group 2 patients with marginal statistical difference.
Conclusion : Patients with large tricuspid annulus, low LVEF, large RVEDV might not get the benefit from PVR in terms of TR. These patients might need concomitant tricuspid valve repair at the time of PVR.
Methods : From June, 2001 to December, 2014, a total of 172 patients underwent surgical PVR. The medical records were retrospectively reviewed.
Results : Among 165 patients whose preoperative echocardiography data was available, 57 (34.5 %) patients showed TR of more than moderate. These patients were older than the patients without significant TR (25.1 ± 12.3 versus 19.5 ± 10.1 years, p < 0.01), and they had larger right ventricular end-diastolic dimension (54.3 ± 10.3 versus 48.0 ± 7.4 mm, p < 0.01) and lower left ventricular ejection fraction (LVEF, 55.6 ±10.8 versus 60.1 ± 7.5 %, p < 0.01). The preoperative arrhythmia was more prevalent in the patients with significant TR. In 39 patients with significant TR who did not undergo concomitant tricuspid valve surgery, the degree of TR improved in 16 patients (41 %, group 1), while the rest of the patients had similar or worsened TR (59 %, group 2). In group 2, the patients had larger tricuspid annulus (33.5 ± 5.6 versus 29.5 ± 8.7 mm, p = 0.04), low LVEF (56.9 ± 10.2 versus 61.2 ± 6.6%, p = 0.04), and larger right ventricular end-diastolic volume (RVEDV, 307.1 ± 52.9 versus 278.6 ± 48.7 ml, p = 0.04). In the univariate analysis, these variables were associated with group 2 patients with marginal statistical difference.
Conclusion : Patients with large tricuspid annulus, low LVEF, large RVEDV might not get the benefit from PVR in terms of TR. These patients might need concomitant tricuspid valve repair at the time of PVR.
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