Abstract 3550: Assessment of Hemodynamic Effects of Surgical Correction for Severe Functional Tricuspid Regurgitation: Cardiac Magnetic Resonance Imaging Study
Background: There has been growing attention for functional TR long after left-sided valve surgery. We tried to determine the long-term hemodynamic effects of corrective surgery for severe functional tricuspid regurgitation (TR) in patients with prior left-sided valve surgery using cardiac magnetic resonance imaging (CMR).
Methods: 29patients with severe functional TR were analyzed. CMR was performed within 1 month before and at a median 27.5 months after surgery.
Results: Long after TR surgery, 26 of the 29 patients had no or mild residual TR, 2 had mild to moderate TR, and 1 showed moderate TR. Remarkable reductions in the right ventricular (RV) end-diastolic volume index (RV-EDVI) and end-systolic volume index (RV-ESVI) were observed, whereas RV ejection fraction showed no change (Table⇓). Preoperative RV-EDVI (R= −0.85, P<0.001) and RV-ESVI (R= −0.55, P=0.002) were significantly associated with their respective changes after corrective surgery. Post-surgery, a normal RV ejection fraction (defined as >40%) was achieved in 25 patients (86.2%). A significant rise in the left ventricular (LV) EDVI and cardiac index (CI) was found after surgery (Table⇓ and Figure⇓⇓). Functional capacity as assessed by NYHA class showed a significant improvement from 2.8±0.6 before surgery to 2.0±0.6 long after surgery (P<0.001).
Conclusion: CMR demonstrated remarkable improvement in RV volumes and the achievement of a normal RV-EF after corrective surgery in a majority of patients with functional severe TR. In addition, successful TR surgery leads to a significant rise in LV volumes and CI, which may contribute to significant amelioration in functional capacity of the patients.