ABSTRACT
BACKGROUND:
It is unclear to what degree of tricuspid annulus (TA) reduction is necessary to achieve good postoperative results in surgical bicuspidization. The study aimed to evaluate TA and right
heart chamber's dimensions before and after
heart surgery; and to compare TA
parameters assessed by different modalities.
METHODS:
Forty
patients underwent
mitral valve surgery with or without concomitant
tricuspid valve (TV) bicuspidization. Preoperative and postoperative measurements of TA dimensions were performed prospectively using two-dimensional (2D) and three-dimensional (3D)
transthoracic echocardiography (TTE). Additionally, preoperative
transesophageal echocardiography (
TOE) was performed in the
operating room prior to
surgery.
RESULTS:
All
patients had no or mild TR immediately after
surgery. There was a significant reduction in 2D and 3D
parameters of the TV and right
chambers in the TV bicuspidization group. However, TV leaflets' tethering
parameters did not change significantly. Preoperative 3D TTE measurements were smaller than those obtained through 3D
TOE in the operation room, before
surgery under
general anesthesia. The 2D systolic apical 4Ch diameter and the parasternal short axis diameter mainly represent the 3D
minor axis of the TA and are smaller than its 3D major axis.
CONCLUSIONS:
Although bicuspidization results in a one-third reduction of the TV area, tethering of the TV leaflets remains unchanged. Moreover, 3D
TOE parameters of the TV under
general anesthesia are larger than preoperative 3D TTE measurements. Conventional 2D measurements are insufficient for evaluating the maximum diameter of the TA.
