Outcomes and Echocardiographic Follow-up After Surgical Management of Tricuspid Regurgitation in Patients With Transvenous Right Ventricular Leads

被引:4
|
作者
Huang, Ying [1 ]
Dearani, Joseph A. [1 ]
Saran, Nishant [1 ]
Stulak, John M. [1 ]
Greason, Kevin L. [1 ]
Crestanello, Juan A. [1 ]
Daly, Richard C. [1 ]
Pochettino, Alberto [1 ]
Lahr, Brian D. [2 ]
Lin, Grace [3 ]
Schaff, Hartzell, V [1 ]
机构
[1] Mayo Clin, Dept Cardiovasc Surg, Rochester, MN USA
[2] Mayo Clin, Dept Biomed Stat & Informat, Rochester, MN USA
[3] Mayo Clin, Dept Cardiovasc Med, Rochester, MN USA
关键词
PERMANENT PACEMAKER; VALVE; DEFIBRILLATORS; SOCIETY; REPAIR;
D O I
10.1016/j.mayocp.2020.11.034
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objective: To evaluate outcomes of elective surgical management of tricuspid regurgitation (TR) in patients with transvenous right ventricular leads, and compare results between non-lead-induced and lead-induced TR patients. Patients and Methods: We studied patients with right ventricular leads who underwent tricuspid valve surgery from January 1, 1993, through December 31, 2015, and categorized them as non-lead-induced and lead-induced TR. Propensity score (PS) for the tendency to have lead-induced TR was estimated from logistic regression and was used to adjust for group differences. Results: From the initial cohort of 470 patients, 444 were included in PS-adjustment analyses (174 non-lead-induced TRs [123 repairs, 51 replacements], 270 lead-induced TRs [129 repairs, 141 replacements]). In PS-adjusted multivariable analysis, lead-induced TR was not associated with mortality (P = . 73), but tricuspid valve replacement was (hazard ratio, 1.59; 95% CI, 1.13 to 2.25; P= .008). Five-year freedom from tricuspid valve re-intervention was 100% for non-lead-induced TR and 92.3% for lead-induced TR; rates adjusted for PS differed between groups (P= .005). There was significant improvement in TR postoperatively in each group (P<.001). In patients having tricuspid valve repair, TR grades tended to worsen over time, but the difference in trends was not significantly different between groups. Conclusion: Lead-induced TR did not affect long-term survival after elective tricuspid valve surgery. In patients with lead-induced TR, tricuspid valve re-intervention was more common. Improvement in TR was achieved in both groups after surgery; however, severity of TR tended to increase over followup after tricuspid valve repair. (C) 2021 Mayo Foundation for Medical Education and Research
引用
收藏
页码:2133 / 2144
页数:12
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