The necessity for tricuspid valve repair can be determined intraoperatively by two-dimensional echocardiography

Goldman, Martin E.; Guarino, Theresa; Fuster, Valentín; Mindich, Bruce P.

doi:10.1016/s0022-5223(19)36217-8

Cited by 53 publications

(9 citation statements)

References 25 publications

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“…In our study tricuspid annulus diameter (and area) could be reliably obtained with RT3DE. Tricuspid annulus measurement is of critical importance in the TV surgical decision-making process if a patient is operated for mitral valve disease and has concomitant TV regurgitation [ 18 , 19 ]. In addition, TV area could be reliably obtained and this may have important implications for the diagnosis of tricuspid stenosis [ 20 , 21 ].…”

Section: Discussionmentioning

confidence: 99%

Assessment of normal tricuspid valve anatomy in adults by real-time three-dimensional echocardiography

Anwar

Geleijnse

Soliman

et al. 2007

Int J Cardiovasc Imaging

136

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Background The tricuspid valve (TV) is a complex structure. Unlike the aortic and mitral valve it is not possible to visualize all TV leaflets simultaneously in one cross-sectional view by standard two-dimensional echocardiography (2DE) either transthoracic or transesophageal due to the position of TV in the far field. Aim Quantitative and qualitative assessment of the normal TV using real-time 3-dimensional echocardiography (RT3DE). Methods RT3DE was performed for 100 normal adults (mean age 30 ± 9 years, 65% males). RT3DE visualization was evaluated by 4-point score (1: not visualized, 2: inadequate, 3: sufficient, and 4: excellent). Measurements included TV annulus diameters (TAD), TV area (TVA), and commissural width. Results In 90% of patients with good 2DE image quality, it was possible to analyse TV anatomy by RT3DE. A detailed anatomical structure including unique description and measurement of tricuspid annulus shape and size, TV leaflets shape, and mobility, and TV commissural width were obtained in majority of patients. Identification of each TV leaflet as seen in the routine 2DE views was obtained. Conclusion RT3DE of the TV is feasible in a large number of patients. RT3DE may add to functional 2DE data in description of TV anatomy and providing highly reproducible and actual reality (anatomical and functional) measurements.

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Section: Discussionmentioning

confidence: 99%

Assessment of normal tricuspid valve anatomy in adults by real-time three-dimensional echocardiography

Anwar

Geleijnse

Soliman

et al. 2007

Int J Cardiovasc Imaging

136

View full text Add to dashboard Cite

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“…TAD measurements have an important role in the TV surgical decision-making process not only for the selection of patients undergoing surgery, but also the type of surgical technique (valve plication or ring placement) [ 13 – 15 ]. Although 2DE is helpful to assess TV function and to detect TR severity it has important limitations in describing TV morphological details, such as TAD [ 14 , 15 ].…”

Section: Discussionmentioning

confidence: 99%

Value of assessment of tricuspid annulus: real-time three-dimensional echocardiography and magnetic resonance imaging

Anwar

Soliman

Nemes

et al. 2007

Int J Cardiovasc Imaging

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Aim To detect the accuracy of real-time threedimensional echocardiography (RT3DE) and two-dimensional echocardiography (2DE) for tricuspid annulus (TA) assessment compared with magnetic resonance imaging (MRI). Methods Thirty patients (mean age 34 ± 13 years, 60% males) in sinus rhythm were examined by MRI, RT3DE, and 2DE for TA assessment. End-diastolic and end-systolic TA diameter (TAD) and TA fractional shortening (TAFS) were measured by RT3DE, 2DE, and MRI. End-diastolic and end-systolic TA area (TAA) and TA fractional area changes (TAFAC) were measured by RT3DE and MRI. End-diastolic and end-systolic right ventricular (RV) volumes and ejection fraction (RV-EF) were measured by MRI. Results The TA was clearly delineated in all patients and visualized as an oval-shaped by RT3DE and MRI. There was a good correlation between TAD MRI and TAD 3D (r = 0.75, P = 0.001), while TAD 2D was fairly correlated with TAD 3D and TAD MRI (r = 0.5, P = 0.01 for both). There were no significant differences between RT3DE and MRI in TAD, TAA, TAFS, and TAFAC measurements, while TAD 2D and TAFS 2D were significantly underestimated (P < 0.001). TAFS 2D was not correlated with RV-EF, while TAFS 3D and TAFAC 3D were fairly correlated with RV-EF (r = 0.49, P = 0.01, and r = 0.47, P = 0.02 respectively). Conclusion RT3DE helps in accurate assessment of TA comparable to MRI and may have an important implication in the TV surgical decisionmaking processes. RT3DE analysis of TA function could be used as a marker of RV function.

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“…Tricuspid annular dilatation, as measured by preoperative or intraoperative echocardiography, has been recommended as an indication for TVR by several authors [ 13 , 18 , 19 ] based on the observation that the TAD was correlated with the severity of TR. Following this recommendation, tricuspid annular dilatation was used as an indication for TVR at the time of mitral valve surgery by Tager et al [ 20 ] (TAD ≥30 mm), Colombo et al [ 21 ] (indexed TAD ≥21 mm/m 2 ), Van de Veire et al [ 22 ] (TAD ≥40 mm), and Calafiore et al [ 23 ] (systolic TAD ≥24 mm).…”

Section: Discussionmentioning

confidence: 99%

Severe tricuspid regurgitation after mitral valve surgery: the risk factors and results of the aggressive application of prophylactic tricuspid valve repair

et al. 2016

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PurposeThis study aimed to examine the risk factors for severe postoperative tricuspid regurgitation (TR) in patients undergoing mitral valve surgery. We also studied the effects of prophylactic tricuspid valve repair (TVR) on severe postoperative TR.MethodsWe retrospectively studied 125 patients without severe TR who underwent mitral valve surgery from 1987 to 2006. Patients did not undergo TVR before 1998 (the early period, n = 54). In 1998 (the late period, n = 71), patients with a preoperative tricuspid annular diameter of ≥35 mm underwent TVR using an annuloplasty ring (n = 52).ResultsIn the analysis of the early period, the rates of freedom from severe TR at 10 and 20 years after surgery were 76 and 59 %, respectively. A multivariate analysis identified moderate preoperative TR as a significant risk factor for severe TR. In the late period, none of the 52 patients who underwent TVR developed severe TR. However, 4/19 patients who did not undergo TVR developed severe TR, and all of these four patients had a preoperative tricuspid annular diameter of ≤35 mm.ConclusionsModerate preoperative TR is a significant risk factor for severe postoperative TR in patients undergoing mitral valve surgery. The aggressive application of TVR can prevent severe postoperative TR; however, tricuspid annular dilatation might not be a good indicator for TVR.

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The necessity for tricuspid valve repair can be determined intraoperatively by two-dimensional echocardiography

Cited by 53 publications

References 25 publications

Assessment of normal tricuspid valve anatomy in adults by real-time three-dimensional echocardiography

Assessment of normal tricuspid valve anatomy in adults by real-time three-dimensional echocardiography

Value of assessment of tricuspid annulus: real-time three-dimensional echocardiography and magnetic resonance imaging

Severe tricuspid regurgitation after mitral valve surgery: the risk factors and results of the aggressive application of prophylactic tricuspid valve repair

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