Effect of Patient-Prosthesis Mismatch in Aortic Position on Late-Onset Tricuspid Regurgitation and Clinical Outcomes after Double Valve Replacement
Yonsei Medical Journal
; : 968-974, 2017.
Article
em En
| WPRIM
| ID: wpr-26745
Biblioteca responsável:
WPRO
ABSTRACT
PURPOSE:
Significant late-onset tricuspid regurgitation (TR) is unfortunately common after double valve replacement (DVR); however, its underlying factors remain undefined. We evaluated the effect of aortic patient-prosthesis mismatch (PPM) on late-onset TR and clinical outcomes after DVR. MATERIALS ANDMETHODS:
Of the 2392 consecutive patients who underwent aortic valve replacement between January 1990 and May 2014 at our institution, we retrospectively studied 462 patients who underwent DVR (excluding concomitant tricuspid valvular annuloplasty or replacement). Survival and freedom from grade >3 TR were compared between PPM (n=152) and non-PPM (n=310) groups using the Kaplan-Meier method.RESULTS:
Although the overall survival rates were similar between the two groups at 5 and 10 years (95%, 91% vs. 96%, 93%, p=0.412), grade >3 TR-free survival was significantly lower in the PPM group (98%, 91% vs. 99%, 95%, p=0.014). Small body-surface area, atrial fibrillation, PPM, and subaortic pannus were risk factors for TR progression. However, aortic prosthesis size and trans-valvular pressure gradient were not significant factors for either TR progression or overall survival.CONCLUSION:
Aortic PPM in DVR, regardless of mitral prosthesis size, was associated with late TR progression, but was not significantly correlated with overall survival. Therefore, we recommend careful echocardiographic follow-up for the early detection of TR progression in patients with aortic PPM in DVR.Palavras-chave
Texto completo:
1
Índice:
WPRIM
Assunto principal:
Valva Aórtica
/
Próteses e Implantes
/
Fibrilação Atrial
/
Insuficiência da Valva Tricúspide
/
Ecocardiografia
/
Taxa de Sobrevida
/
Estudos Retrospectivos
/
Fatores de Risco
/
Seguimentos
/
Implante de Prótese de Valva Cardíaca
Tipo de estudo:
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
/
Screening_studies
Limite:
Humans
Idioma:
En
Revista:
Yonsei Medical Journal
Ano de publicação:
2017
Tipo de documento:
Article