Korean J Thorac Cardiovasc Surg.
2003 Mar;36(3):136-141.
Intermediate-term Result of Tricuspid Annuloplasty for Tricuspid Regurgitation Associated with Congenital Heart Disease in Adult
- Affiliations
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- 1Department of Thoracic and Cardiovascular Surgery, College of Medicine, University of Ulsan, Korea. tjy3589@hotmail.com
- 2Department of Internal Medicine, College of Medicine, University of Ulsan, Korea.
- 3Department of Pediatrics, College of Medicine, University of Ulsan, Korea.
Abstract
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BACKGROUND: We assessed the intermediate-term result of tricuspid annuloplasty (TAP) for tricuspid valve regurgitation (TR) associated with congenital heart disease in adults. Risk factors for residual TR were also analysed.
MATERIAL AND METHOD: From August 1989 to June 2001, seventy three adult patients, 51 females and 22 males, underwent TAP for TR associated with various congenital heart disease. Their age ranged from 16 years to 73 years (mean:43). Associated heart anomalies were atrial septal defect (55), ventricular
septal defect (6), partial anomalous pulmonary venous return (4) and others (8). Preoperative and postoperative TR velocities were 3.25 m/sec and 2.56 m/sec respectively, and the types of TAP were De Vega in 43, Kay in 18 and Ring annuloplasty in 12. Postoperative follow-up duration was 2,347 patient-month (mean: 32.6 months), and 134 two-dimensional echocardiographic examinations were done during this period. Residual TR greater than III/IV was considered as TAP failure.
RESULT: TAP failure was observed in 7 patients (9.6%), and one patient among them underwent tricuspid valve replacement. Risk factors for TAP
failure were diagnosis other than atrial septal defect (p=0.001), preoperative (p=0.038) and postoperative (p=0.028) high TR velocity. There was no statistical significance in terms of TAP methods.
CONCLUSION
Careful evaluation of valve morphology and aggressive surgical intervention are mandatory for the repair of TR with preoperative or residual RV pressure overload.
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