Premium
Impact of additional annuloplasty on tricuspid valve and cardiac functions after atrial septal defect closure in adults
Author(s) -
Guler Salih,
Reyhancan Adem,
Kubat Emre,
Onan Ismihan Selen,
Kadirogullari Ersin,
Onan Burak
Publication year - 2020
Publication title -
journal of cardiac surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.428
H-Index - 58
eISSN - 1540-8191
pISSN - 0886-0440
DOI - 10.1111/jocs.14905
Subject(s) - medicine , cardiology , tricuspid valve , pulmonary artery , regurgitation (circulation) , diastolic function , body surface area , diastole , surgery , blood pressure
Abstract Background Surgical indications for moderate to severe tricuspid regurgitation (TR) during atrial septal defect (ASD) closure are still unclear. Additional tricuspid valve annuloplasty (TVP) can be beneficial to avoid postoperative persistent TR. Therefore, we compared the results of surgical ASD closure with or without additional TVP in patients who presented with moderate‐to‐severe TR. Methods Between November 2009 and June 2016, 103 patients with ASD and moderate‐to‐severe TR underwent surgical ASD closure without (n = 76, group 1) and with additional TVP (n = 27, group 2). Clinical outcomes and echocardiographic data were analyzed. Results There was no mortality. Postoperative outcomes were similar despite significantly longer aortic clamping time in group 2 ( P = .003). Mean TR grade, right atrial diameter, right ventricular end‐diastolic diameter, pulmonary artery pressure, and Qp/Qs ratio decreased significantly in both groups ( P < .05). Mean follow‐up time was 5.3 months (range: 1 month‐6.2 years) in group 1 and 6.1 months (range: 1 month‐4.1 years) in group 2 ( P = .66). Echocardiography results showed significant decrease in TR grade in both groups ( P = .93). The incidence of persistent moderate to severe TR was higher in isolated ASD closure group (14.4% vs 3.7%, P = .086). Additional TVP provided greater regression in TR grade (−1.49 ± 0.9 vs −1.89 ± 0.8, P = .041). Conclusion Despite TVP being associated with longer ischemic time, postoperative outcomes were comparable to ASD closure alone. Both approach demonstrated an effective decrease in TR, but TVP provided greater regression and lower incidence of persistent TR. Therefore, additional TVP should be considered in patients undergoing ASD closure with moderate‐to‐severe TR.