PMID- 15620928
OWN - NLM
STAT- MEDLINE
DCOM- 20050812
LR  - 20220318
IS  - 1552-6259 (Electronic)
IS  - 0003-4975 (Linking)
VI  - 79
IP  - 1
DP  - 2005 Jan
TI  - Secondary tricuspid regurgitation or dilatation: which should be the criteria for 
      surgical repair?
PG  - 127-32
AB  - BACKGROUND: Secondary tricuspid dilatation may or not be accompanied by tricuspid 
      regurgitation (TR). Tricuspid dilatation can be objectively measured whereas TR 
      can vary according to the preload, afterload, and right ventricular function. The 
      purpose of this prospective study was to determine whether surgical repair of the 
      tricuspid valve based on tricuspid dilatation rather than TR could lead to 
      potential benefits. METHODS: Between 1989 and 2001, 311 patients underwent mitral 
      valve repair (MVR). The tricuspid valve was examined in each patient. Tricuspid 
      annuloplasty was performed only if the tricuspid annular diameter was greater 
      than twice the normal size (> or = 70 mm) regardless of the grade of 
      regurgitation. Patients in group 1 (163 patients; 52.4%) received MVR alone. 
      Patients in group 2 (148 patients; 47.6%) received MVR plus tricuspid 
      annuloplasty. RESULTS: Although not significant there was a difference with 
      regard to hospital mortality (group 1 = 1.8%, group 2 = 0.7%) and actuarial 
      survival rate (Kaplan-Meier: group 1 = 97.3%, 96.2%, and 85.5%; group 2 = 98.5%, 
      98.5%, and 90.3% at 3, 5, and 10 years, respectively). The New York Heart 
      Association (NYHA) functional class was significantly improved in group 2 (group 
      1 = 1.59 +/- 0.84; group 2 = 1.11 +/- 0.31; p1). TR increased by more than two 
      grades in 48% of the patients in group 1 and in only 2% of the patients in group 
      2 (p < 0.001). CONCLUSIONS: Remodeling annuloplasty of the tricuspid valve based 
      on tricuspid dilation improves functional status irrespective of the grade of 
      regurgitation. Considerable tricuspid dilatation can be present even in the 
      absence of substantial TR. Tricuspid dilatation is an ongoing disease process 
      that will, with time, lead to severe TR.
FAU - Dreyfus, Gilles D
AU  - Dreyfus GD
AD  - Department of Cardiothoracic Surgery, Royal Brompton and Harefield NHS Trust, 
      Harefield Hospital, Harefield, Middlesex, United Kingdom. 
      g.dreyfus@rbh.nthames.nhs.uk
FAU - Corbi, Pierre J
AU  - Corbi PJ
FAU - Chan, K M John
AU  - Chan KM
FAU - Bahrami, Toufan
AU  - Bahrami T
LA  - eng
PT  - Comparative Study
PT  - Evaluation Study
PT  - Journal Article
PL  - Netherlands
TA  - Ann Thorac Surg
JT  - The Annals of thoracic surgery
JID - 15030100R
SB  - IM
MH  - Adult
MH  - Aged
MH  - Dilatation, Pathologic/complications/surgery
MH  - Disease Progression
MH  - Disease-Free Survival
MH  - Female
MH  - Follow-Up Studies
MH  - Heart Failure/etiology
MH  - Heart Valve Diseases/complications/diagnosis/*surgery
MH  - Hospital Mortality
MH  - Humans
MH  - Life Tables
MH  - Male
MH  - Middle Aged
MH  - Mitral Valve Insufficiency/complications/surgery
MH  - Postoperative Complications/mortality
MH  - Prospective Studies
MH  - Survival Analysis
MH  - Treatment Outcome
MH  - Tricuspid Valve/pathology/*surgery
MH  - Tricuspid Valve Insufficiency/complications/diagnosis/*surgery
EDAT- 2004/12/29 09:00
MHDA- 2005/08/13 09:00
CRDT- 2004/12/29 09:00
PHST- 2004/06/04 00:00 [accepted]
PHST- 2004/12/29 09:00 [pubmed]
PHST- 2005/08/13 09:00 [medline]
PHST- 2004/12/29 09:00 [entrez]
AID - S0003-4975(04)01385-2 [pii]
AID - 10.1016/j.athoracsur.2004.06.057 [doi]
PST - ppublish
SO  - Ann Thorac Surg. 2005 Jan;79(1):127-32. doi: 10.1016/j.athoracsur.2004.06.057.