Surgery for Functional Tricuspid Regurgitation in Adult Atrial Septal Defect — An Increasing Subject in a Decreasing Matter
Rev. bras. cir. cardiovasc
; 37(3): 306-314, May-June 2022. tab
Article
em En
|
LILACS-Express
| LILACS
| ID: biblio-1376553
Biblioteca responsável:
BR1.1
ABSTRACT
ABSTRACT Introduction:
Functional tricuspid regurgitation (TR) is known to complicate adult atrial septal defect (ASD), but its management is still under debate. We reviewed our experience in ASD surgery, focusing on associated functional TR and its treatment.Methods:
This retrospective study (2005-2019) included 206 consecutive adult ASD surgical cases without associated valve pathology, except functional TR. Variables were statistically compared on TR classes and surgery-defined groups.Results:
Mean age of the patients was 40.3±13 years; 19.9% had sinus venosus syndrome. TR severity was directly related to age, pulmonary systolic pressure, right ventricular and tricuspid annulus diameters, and heart failure class. TR ≥ 2 was found in 134 (65%) patients, while TR ≥ 3 in 56 (27.2%) patients. Tricuspid surgery was associated to shunt closure in 66 (32%) patients, almost all through valve repair; indication was directly related to age, right ventricular and tricuspid annulus diameters, and heart failure class ≥ 3. Tricuspid surgery was more efficient than isolated shunt closure in decreasing TR (79±23% vs. 36±26%; P=1.8 E-18). Device closure availability (last four years of the study) was associated with 1/3 reduction of surgical cases but increased the share of cases with TR>2 (> 51% vs. < 31%; P<0.05).Conclusion:
In the era of device closure, surgery for adult ASD is less frequent, but the share of significant TR cases is in net increase. To avoid long-term postoperative TR, we plead for valve repair in all patients with severe TR and for considering repair in moderate TR at risk of persistence.
Texto completo:
1
Coleções:
01-internacional
Temas:
Geral
/
Cirurgia_oncologica
Base de dados:
LILACS
Tipo de estudo:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Idioma:
En
Revista:
Rev. bras. cir. cardiovasc
Assunto da revista:
CARDIOLOGIA
/
CIRURGIA GERAL
Ano de publicação:
2022
Tipo de documento:
Article
País de afiliação:
Romênia