Severe tricuspid regurgitation is predictive for adverse events in tetralogy of Fallot.
Heart
; 101(10): 794-9, 2015 May 15.
Article
em En
| MEDLINE
| ID: mdl-25828460
ABSTRACT
OBJECTIVE:
Patients with surgically repaired tetralogy of Fallot (rTOF) may develop functional tricuspid regurgitation (TR) due to annulus dilation. Guidelines suggest pulmonary valve replacement (PVR) in patients with rTOF with progressive TR, but data on clinical outcomes are lacking. Our objective was to determine whether TR was predictive for adverse events after PVR.METHODS:
In this retrospective, multicenter cohort study, patients with rTOF who had undergone PVR after preoperative echocardiographic assessment of TR grade were included. Preoperative and postoperative imaging data and a composite of adverse clinical events (death, sustained ventricular tachycardia, heart failure, or supraventricular tachycardia) were collected. Multivariate Cox hazards regression analysis was used to determine which factors were predictive for adverse events after PVR.RESULTS:
A total of 129 patients (61% men, age at PVR 32.9±10.4â years) were included. The composite endpoint occurred in 39 patients during 8.4±4.2â years of follow-up. In multivariate analysis, severe preoperative TR (HR 2.49, 95% CI 1.11 to 5.52), right ventricular end-systolic volume (HR 1.02/mL/m(2), 95% CI 1.01 to 1.03) and age at PVR (HR 1.07/year, 95% CI 1.04 to 1.09) were predictive for adverse events. Early postoperative TR was not predictive for adverse events (p=0.96). In patients without any risk factor (age >40â years, right ventricular end-systolic volume >90â mL/m(2) or severe TR), 5-year event-free survival was 100% as compared with 61% in patients with two or three risk factors.CONCLUSIONS:
In patients with rTOF, severe preoperative TR was predictive for adverse events after PVR. Close surveillance is warranted in these patients irrespective of postoperative TR.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Insuficiência da Valva Pulmonar
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Estenose da Valva Pulmonar
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Tetralogia de Fallot
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Insuficiência da Valva Tricúspide
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Implante de Prótese de Valva Cardíaca
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Procedimentos Cirúrgicos Cardíacos
Tipo de estudo:
Diagnostic_studies
/
Etiology_studies
/
Guideline
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Adult
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Female
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Humans
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Male
País como assunto:
Europa
Idioma:
En
Ano de publicação:
2015
Tipo de documento:
Article