Abstract
Background, The impact of echocardiographic-guided treatment on outcome after tricuspid valve (TV) surgery is not well defined. Objectives. The purpose of this study was to determine clinical and echocardiographic factors associated with adverse outcomes after TV surgery and determine the role of intraoperative echo (IOE) in facilitating successful outcomes after TV surgery. Methods. Four hundred and one patients (279 females, mean age 60 years) underwent TV surgery and other concomitant cardiac surgery at a single institution and were followed clinically and by echocardiography during a 10- year period. Results. Decreased survival after TV surgery was associated with: preoperative increased New York Heart Association (NYHA) functional classification (relative risk [RR] = 2.02), increased left ventricular dysfunction by echocardiography (RR = 1.28), and use of a TV replacement strategy (RR = 2.92). Decreased event-free survival after TV surgery was associated with concomitant coronary artery bypass grafting (RR = 2.97). Late echocardiographic failure (3 to 4+ tricuspid valve regurgitation [TR]) after TV surgery was associated with increased severity of TR on preoperative echocardiogram (odds ratio [OR] = 1.91). Decreased late echocardiographic failure after TV surgery was associated with the use of a TV annuloplasty ring with a repair strategy (OR = 0.40). The surgical plan was altered at the time of surgery to insure a successful outcome in 32 (10%) of 335 patients based on IOE findings. Conclusions. Adverse outcomes after TV surgery can be predicted by several preoperative clinical and echocardiographic variables. IOE is useful in improving immediate, but not late, outcomes after TV surgery.
| Original language | English |
|---|---|
| Pages (from-to) | 1023-1031 |
| Number of pages | 9 |
| Journal | Journal of the American College of Cardiology |
| Volume | 32 |
| Issue number | 4 |
| DOIs | |
| State | Published - Oct 1 1998 |
| Externally published | Yes |
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ASJC Scopus subject areas
- Nursing(all)
Cite this
Tricuspid valve surgery and intraoperative echocardiography : Factors affecting survival, clinical outcome, and echocardiographic success. / Bajzer, Christopher T.; Stewart, William J.; Cosgrove, Delos M.; Azzam, Sami J.; Arheart, Kristopher; Klein, Allan L.
In: Journal of the American College of Cardiology, Vol. 32, No. 4, 01.10.1998, p. 1023-1031.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Tricuspid valve surgery and intraoperative echocardiography
T2 - Factors affecting survival, clinical outcome, and echocardiographic success
AU - Bajzer, Christopher T.
AU - Stewart, William J.
AU - Cosgrove, Delos M.
AU - Azzam, Sami J.
AU - Arheart, Kristopher
AU - Klein, Allan L.
PY - 1998/10/1
Y1 - 1998/10/1
N2 - Background, The impact of echocardiographic-guided treatment on outcome after tricuspid valve (TV) surgery is not well defined. Objectives. The purpose of this study was to determine clinical and echocardiographic factors associated with adverse outcomes after TV surgery and determine the role of intraoperative echo (IOE) in facilitating successful outcomes after TV surgery. Methods. Four hundred and one patients (279 females, mean age 60 years) underwent TV surgery and other concomitant cardiac surgery at a single institution and were followed clinically and by echocardiography during a 10- year period. Results. Decreased survival after TV surgery was associated with: preoperative increased New York Heart Association (NYHA) functional classification (relative risk [RR] = 2.02), increased left ventricular dysfunction by echocardiography (RR = 1.28), and use of a TV replacement strategy (RR = 2.92). Decreased event-free survival after TV surgery was associated with concomitant coronary artery bypass grafting (RR = 2.97). Late echocardiographic failure (3 to 4+ tricuspid valve regurgitation [TR]) after TV surgery was associated with increased severity of TR on preoperative echocardiogram (odds ratio [OR] = 1.91). Decreased late echocardiographic failure after TV surgery was associated with the use of a TV annuloplasty ring with a repair strategy (OR = 0.40). The surgical plan was altered at the time of surgery to insure a successful outcome in 32 (10%) of 335 patients based on IOE findings. Conclusions. Adverse outcomes after TV surgery can be predicted by several preoperative clinical and echocardiographic variables. IOE is useful in improving immediate, but not late, outcomes after TV surgery.
AB - Background, The impact of echocardiographic-guided treatment on outcome after tricuspid valve (TV) surgery is not well defined. Objectives. The purpose of this study was to determine clinical and echocardiographic factors associated with adverse outcomes after TV surgery and determine the role of intraoperative echo (IOE) in facilitating successful outcomes after TV surgery. Methods. Four hundred and one patients (279 females, mean age 60 years) underwent TV surgery and other concomitant cardiac surgery at a single institution and were followed clinically and by echocardiography during a 10- year period. Results. Decreased survival after TV surgery was associated with: preoperative increased New York Heart Association (NYHA) functional classification (relative risk [RR] = 2.02), increased left ventricular dysfunction by echocardiography (RR = 1.28), and use of a TV replacement strategy (RR = 2.92). Decreased event-free survival after TV surgery was associated with concomitant coronary artery bypass grafting (RR = 2.97). Late echocardiographic failure (3 to 4+ tricuspid valve regurgitation [TR]) after TV surgery was associated with increased severity of TR on preoperative echocardiogram (odds ratio [OR] = 1.91). Decreased late echocardiographic failure after TV surgery was associated with the use of a TV annuloplasty ring with a repair strategy (OR = 0.40). The surgical plan was altered at the time of surgery to insure a successful outcome in 32 (10%) of 335 patients based on IOE findings. Conclusions. Adverse outcomes after TV surgery can be predicted by several preoperative clinical and echocardiographic variables. IOE is useful in improving immediate, but not late, outcomes after TV surgery.
UR - http://www.scopus.com/inward/record.url?scp=0032192144&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0032192144&partnerID=8YFLogxK
U2 - 10.1016/S0735-1097(98)00355-6
DO - 10.1016/S0735-1097(98)00355-6
M3 - Article
VL - 32
SP - 1023
EP - 1031
JO - Journal of the American College of Cardiology
JF - Journal of the American College of Cardiology
SN - 0735-1097
IS - 4
ER -