Incidence of and Risk Factors for the Development of Significant Tricuspid Regurgitation after Isolated Aortic Valve Replacement.

Q4 Medicine Journal of Chest Surgery Pub Date : 2023-09-05 DOI:10.5090/jcs.22.147
Minsang Kang, Jae Woong Choi, Suk Ho Sohn, Ho Young Hwang, Kyung Hwan Kim
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引用次数: 1

Abstract

Background: The late progression of tricuspid regurgitation (TR) after mitral valve surgery is well known. However, few reports have described the progression of TR after aortic valve surgery. We investigated the incidence of and risk factors for the development of significant TR after isolated aortic valve replacement (AVR).

Methods: This study analyzed patients with less than moderate TR who underwent isolated AVR at Seoul National University Hospital from January 1990 to December 2018. Significant TR was defined as moderate or higher. Echocardiographic follow-up was performed in all patients. The Fine-Gray model was used to identify clinical risk factors for the development of significant TR.

Results: In total, 583 patients (61.7±14.2 years old) were included. Operative mortality occurred in 9 patients (1.5%), and the overall survival rates at 10, 20, and 25 years were 91.1%, 83.2%, and 78.9%, respectively. Sixteen patients (2.7%) developed significant TR during the follow-up period (13 moderate; 3 severe). The cumulative incidence of significant TR at 10, 20, and 25 years was 0.77%, 3.83%, and 6.42%, respectively. No patients underwent reoperation or reintervention of the tricuspid valve. Hemodialysis or peritoneal dialysis for chronic kidney disease (hazard ratio [HR], 5.188; 95% confidence interval [CI], 1.154-23.322) and preoperative mild TR (HR, 5.919; 95% CI, 2.059-17.017) were associated with the development of significant TR in the multivariable analysis.

Conclusion: TR progression after isolated AVR in patients with less than moderate TR is rare. Preoperative mild TR and hemodialysis or peritoneal dialysis for chronic kidney disease were significant risk factors for the development of TR.

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孤立主动脉瓣置换术后显著三尖瓣反流的发生率及危险因素。
背景:二尖瓣手术后三尖瓣返流(TR)的晚期进展是众所周知的。然而,很少有报道描述主动脉瓣手术后TR的进展。我们调查了孤立性主动脉瓣置换术(AVR)后发生明显TR的发生率和危险因素。方法:本研究分析了1990年1月至2018年12月在首尔国立大学医院接受孤立AVR的中度以下TR患者。显著TR定义为中度或更高。所有患者均行超声心动图随访。结果:共纳入583例患者(61.7±14.2岁)。手术死亡9例(1.5%),10年、20年、25年总生存率分别为91.1%、83.2%、78.9%。16例(2.7%)患者在随访期间出现明显的TR(中度13例;3严重)。10年、20年和25年显著TR累积发生率分别为0.77%、3.83%和6.42%。无患者再次手术或再次介入三尖瓣。血液透析或腹膜透析治疗慢性肾脏疾病(危险比[HR], 5.188;95%可信区间[CI], 1.154-23.322)和术前轻度TR (HR, 5.919;在多变量分析中,95% CI(2.059-17.017)与显著TR的发生相关。结论:孤立性AVR术后TR进展在中度以下患者中是罕见的。术前轻度TR和慢性肾脏疾病的血液透析或腹膜透析是TR发生的重要危险因素。
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来源期刊
Journal of Chest Surgery
Journal of Chest Surgery Medicine-Surgery
CiteScore
0.80
自引率
0.00%
发文量
76
审稿时长
7 weeks
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