PMID- 9768728
OWN - NLM
STAT- MEDLINE
DCOM- 19981020
LR  - 20190708
IS  - 0735-1097 (Print)
IS  - 0735-1097 (Linking)
VI  - 32
IP  - 4
DP  - 1998 Oct
TI  - Tricuspid valve surgery and intraoperative echocardiography: factors affecting 
      survival, clinical outcome, and echocardiographic success.
PG  - 1023-31
AB  - BACKGROUND: The impact of echocardiographic-guided treatment on outcome after 
      tricuspid valve (TV) surgery is not well defined. OBJECTIVES: The purpose of this 
      study was to determine clinical and echocardiographic factors associated with 
      adverse outcomes after TV surgery and determine the role of intraoperative echo 
      (IOE) in facilitating successful outcomes after TV surgery. METHODS: Four hundred 
      and one patients (279 females, mean age 60 years) underwent TV surgery and other 
      concomitant cardiac surgery at a single institution and were followed clinically 
      and by echocardiography during a 10-year period. RESULTS: Decreased survival 
      after TV surgery was associated with: preoperative increased New York Heart 
      Association (NYHA) functional classification (relative risk [RR]=2.02), increased 
      left ventricular dysfunction by echocardiography (RR=1.28), and use of a TV 
      replacement strategy (RR=2.92). Decreased event-free survival after TV surgery 
      was associated with concomitant coronary artery bypass grafting (RR=2.97). Late 
      echocardiographic failure (3 to 4+ tricuspid valve regurgitation [TR]) after TV 
      surgery was associated with increased severity of TR on preoperative 
      echocardiogram (odds ratio [OR]=1.91). Decreased late echocardiographic failure 
      after TV surgery was associated with the use of a TV annuloplasty ring with a 
      repair strategy (OR=0.40). The surgical plan was altered at the time of surgery 
      to insure a successful outcome in 32 (10%) of 335 patients based on IOE findings. 
      CONCLUSIONS: Adverse outcomes after TV surgery can be predicted by several 
      preoperative clinical and echocardiographic variables. IOE is useful in improving 
      immediate, but not late, outcomes after TV surgery.
FAU - Bajzer, C T
AU  - Bajzer CT
AD  - Department of Cardiology, The Cleveland Clinic Foundation, Ohio 44106-0001, USA.
FAU - Stewart, W J
AU  - Stewart WJ
FAU - Cosgrove, D M
AU  - Cosgrove DM
FAU - Azzam, S J
AU  - Azzam SJ
FAU - Arheart, K L
AU  - Arheart KL
FAU - Klein, A L
AU  - Klein AL
LA  - eng
PT  - Journal Article
PL  - United States
TA  - J Am Coll Cardiol
JT  - Journal of the American College of Cardiology
JID - 8301365
SB  - IM
MH  - Adult
MH  - Aged
MH  - *Echocardiography
MH  - Female
MH  - Follow-Up Studies
MH  - Heart Valve Prosthesis Implantation
MH  - Humans
MH  - Intraoperative Period
MH  - Male
MH  - Middle Aged
MH  - Postoperative Complications
MH  - Risk Factors
MH  - Survival Rate
MH  - Treatment Outcome
MH  - Tricuspid Valve/*surgery
MH  - Tricuspid Valve Insufficiency/diagnostic imaging/mortality/surgery
EDAT- 1998/10/13 00:00
MHDA- 1998/10/13 00:01
CRDT- 1998/10/13 00:00
PHST- 1998/10/13 00:00 [pubmed]
PHST- 1998/10/13 00:01 [medline]
PHST- 1998/10/13 00:00 [entrez]
AID - S0735-1097(98)00355-6 [pii]
AID - 10.1016/s0735-1097(98)00355-6 [doi]
PST - ppublish
SO  - J Am Coll Cardiol. 1998 Oct;32(4):1023-31. doi: 10.1016/s0735-1097(98)00355-6.