Acta Medica Nagasakiensia
Print ISSN : 0001-6055
ORIGINAL ARTICLES
Risk factors of recurrent tricuspid regurgitation after valve repair with three-dimensional ring
Tessho KitamuraKikuko ObaseShun NakajiIchiro MatsumaruTakashi MiuraKiyoyuki Eishi
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2022 Volume 65 Issue 3 Pages 103-109

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Abstract

Objective: The purpose of this study was to investigate the results of tricuspid valve (TV) repair with three-dimensional ring (3DR) and risk factors of recurrent tricuspid regurgitation (TR). Methods: We retrospectively investigated 171 patients who underwent TV repair with a 3DR for TR from 2007 to 2016 at our institution. The patients were divided into the non-Recurrence group (<2+ TR) and Recurrence group (≥2+ TR), and compared to identify the cause of recurrent TR. The mean follow-up period was 58±35 months. Results: The preoperative TR grade was 3.0±0.8. A total of 22 patients had at least ≥2+ TR in the follow-up period. Freedom from ≥2+ TR and re-operation at 5 years were 83.6±3.3% and 97.9±2.1%. Comparison of the non-Recurrence and Recurrence groups revealed significant differences in the preoperative TR grade (2.9±0.8 and 3.4±0.6, p=0.008), proportion of the patients with left ventricular ejection fraction (LVEF) <40% (9% and 32%, p=0.003) and right ventricular end-systolic dimension (RVDs, 22.8±7.1 mm and 31.1±12.3 mm, P=0.001). In the multivariate analysis, LVEF <40% (hazard ratio: 12.65, 95% confidence interval: 2.66–60.18; p=0.002) and RVDs (hazard ratio: 1.08, 95% confidence interval: 1.02–1.14; p=0.02) were identified as risk factors for recurrent TR. Conclusion: Our results of TV repair with 3DR were of satisfactory. However, patients with preoperative lower LVEF and larger RVDs were identified at risk of recurrent TR. This result suggests the limitation to use of 3DR alone for TV repair and need for additional procedure.

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© 2022 by Nagasaki University School of Medicine
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