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Staging right heart failure in patients with tricuspid regurgitation undergoing tricuspid surgery

OBJECTIVES: This study evaluated the prognostic value of staging right heart failure in patients with significant tricuspid regurgitation (TR) undergoing tricuspid valve (TV) surgery. METHODS: Patients with significant TR who underwent TV surgery were divided into 4 right heart failure stages accord...

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Autores principales: Galloo, Xavier, Stassen, Jan, Butcher, Steele C, Meucci, Maria Chiara, Dietz, Marlieke F, Mertens, Bart J A, Prihadi, Edgard A, van der Bijl, Pieter, Ajmone Marsan, Nina, Braun, Jerry, Bax, Jeroen J, Delgado, Victoria
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9789688/
https://www.ncbi.nlm.nih.gov/pubmed/35511132
http://dx.doi.org/10.1093/ejcts/ezac290
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author Galloo, Xavier
Stassen, Jan
Butcher, Steele C
Meucci, Maria Chiara
Dietz, Marlieke F
Mertens, Bart J A
Prihadi, Edgard A
van der Bijl, Pieter
Ajmone Marsan, Nina
Braun, Jerry
Bax, Jeroen J
Delgado, Victoria
author_facet Galloo, Xavier
Stassen, Jan
Butcher, Steele C
Meucci, Maria Chiara
Dietz, Marlieke F
Mertens, Bart J A
Prihadi, Edgard A
van der Bijl, Pieter
Ajmone Marsan, Nina
Braun, Jerry
Bax, Jeroen J
Delgado, Victoria
author_sort Galloo, Xavier
collection PubMed
description OBJECTIVES: This study evaluated the prognostic value of staging right heart failure in patients with significant tricuspid regurgitation (TR) undergoing tricuspid valve (TV) surgery. METHODS: Patients with significant TR who underwent TV surgery were divided into 4 right heart failure stages according to the presence of right ventricular (RV) dysfunction and clinical signs of right heart failure: stage 1 was defined as no RV dysfunction and no signs of right heart failure; stage 2 indicated RV dysfunction without signs of right heart failure; stage 3 included RV dysfunction and signs of right heart failure; and stage 4 was defined as RV dysfunction and refractory signs of right heart failure at rest. RESULTS: A total of 278 patients [mean age 64 (12), 49% males] were included, of whom 34 (12%) patients were classified as stages 1 and 2, 141 (51%) as stage 3 and 103 (37%) as stage 4 right heart failure. The majority of patients (91%) had TV surgery concomitant to left-sided valve surgery or coronary artery bypass grafting and 95% underwent TV annuloplasty. Cumulative survival rates were 89%, 78% and 61% at 1 month, 1 year and 5 years, respectively. Stages 1 and 2 and stage 3 were independently associated with better survival compared to stage 4 (hazard ratio: 0.391 [95% confidence interval: 0.186–0.823] and 0.548 [95% confidence interval: 0.369–0.813], respectively). CONCLUSIONS: Patients with significant TR undergoing TV surgery and diagnosed without advanced right heart failure have better survival as compared to patients with right heart failure.
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spelling pubmed-97896882022-12-30 Staging right heart failure in patients with tricuspid regurgitation undergoing tricuspid surgery Galloo, Xavier Stassen, Jan Butcher, Steele C Meucci, Maria Chiara Dietz, Marlieke F Mertens, Bart J A Prihadi, Edgard A van der Bijl, Pieter Ajmone Marsan, Nina Braun, Jerry Bax, Jeroen J Delgado, Victoria Eur J Cardiothorac Surg Conventional Valve Operations OBJECTIVES: This study evaluated the prognostic value of staging right heart failure in patients with significant tricuspid regurgitation (TR) undergoing tricuspid valve (TV) surgery. METHODS: Patients with significant TR who underwent TV surgery were divided into 4 right heart failure stages according to the presence of right ventricular (RV) dysfunction and clinical signs of right heart failure: stage 1 was defined as no RV dysfunction and no signs of right heart failure; stage 2 indicated RV dysfunction without signs of right heart failure; stage 3 included RV dysfunction and signs of right heart failure; and stage 4 was defined as RV dysfunction and refractory signs of right heart failure at rest. RESULTS: A total of 278 patients [mean age 64 (12), 49% males] were included, of whom 34 (12%) patients were classified as stages 1 and 2, 141 (51%) as stage 3 and 103 (37%) as stage 4 right heart failure. The majority of patients (91%) had TV surgery concomitant to left-sided valve surgery or coronary artery bypass grafting and 95% underwent TV annuloplasty. Cumulative survival rates were 89%, 78% and 61% at 1 month, 1 year and 5 years, respectively. Stages 1 and 2 and stage 3 were independently associated with better survival compared to stage 4 (hazard ratio: 0.391 [95% confidence interval: 0.186–0.823] and 0.548 [95% confidence interval: 0.369–0.813], respectively). CONCLUSIONS: Patients with significant TR undergoing TV surgery and diagnosed without advanced right heart failure have better survival as compared to patients with right heart failure. Oxford University Press 2022-05-02 /pmc/articles/PMC9789688/ /pubmed/35511132 http://dx.doi.org/10.1093/ejcts/ezac290 Text en © The Author(s) 2022. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Conventional Valve Operations
Galloo, Xavier
Stassen, Jan
Butcher, Steele C
Meucci, Maria Chiara
Dietz, Marlieke F
Mertens, Bart J A
Prihadi, Edgard A
van der Bijl, Pieter
Ajmone Marsan, Nina
Braun, Jerry
Bax, Jeroen J
Delgado, Victoria
Staging right heart failure in patients with tricuspid regurgitation undergoing tricuspid surgery
title Staging right heart failure in patients with tricuspid regurgitation undergoing tricuspid surgery
title_full Staging right heart failure in patients with tricuspid regurgitation undergoing tricuspid surgery
title_fullStr Staging right heart failure in patients with tricuspid regurgitation undergoing tricuspid surgery
title_full_unstemmed Staging right heart failure in patients with tricuspid regurgitation undergoing tricuspid surgery
title_short Staging right heart failure in patients with tricuspid regurgitation undergoing tricuspid surgery
title_sort staging right heart failure in patients with tricuspid regurgitation undergoing tricuspid surgery
topic Conventional Valve Operations
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9789688/
https://www.ncbi.nlm.nih.gov/pubmed/35511132
http://dx.doi.org/10.1093/ejcts/ezac290
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