Abstract 1805: Late Tricuspid Regurgitation after Left-sided Heart Valve Surgery - Single Center Study with 10-year Echocardiographic Follow-up
We investigated the incidence and risk factors of late tricuspid regurgitation(TR) in patients underwent mitral valve (MV) or aortic valve (AV) surgery. A retrospective analysis was performed on 556 patients underwent left-sided valve surgery (287 in MV, 115 in AV, 154 in combined surgery) between 1992 and 1995. Echocardiographic follow-up performed at least 10 years after surgery. The significant TR was defined as more than mild degree. Among 399 patients underwent follow-up echocardiography, the significant TR was identified in 191 patients(34%) and occurred more frequently in MV surgery group (11% in AV, 40% in MV, and 43% in combined surgery, p < 0.05). During follow up, 46 Patients (12%) developed severe TR and 17 patients underwent tricuspid valve surgery. Table 1⇓ shows clinical difference between significant and insignificant TR group. In multivariate logistic analysis, preoperative atrial fibrillation (OR 4.5, p < 0.01), combined MV and AV surgery (OR 4.7, p= 0.02), and right atrial pressure (OR 1.1, p=0.02) were independent predictors in the development of late TR. The survival rate was significantly lower in late TR group (figure 1⇓). Late TR after left-sided valve surgery was common and associated with poor prognosis. Preoperative atrial fibrillation, combined MV and AV surgery, and high preoperative right atrial pressure were identified as independent predictors.