ArticleBrazilian journal of cardiovascular surgery2022
Surgery for Functional Tricuspid Regurgitation in Adult Atrial Septal Defect - An Increasing Subject in a Decreasing Matter.
Article in Brazilian journal of cardiovascular surgery, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed, 1 citations in OpenAlex.
- Robotic repair of atrial septal defect: Pre-groove vertical right atriotomy approach.JTCVS techniques · 2024Article
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6 authors at 2 institutions in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
introductionFunctional tricuspid regurgitation (TR) is known to complicate adult atrial septal defect (ASD), but its management is still under debate. We reviewed our experience in ASD surgery, focusing on associated functional TR and its treatment.
methodsThis retrospective study (2005-2019) included 206 consecutive adult ASD surgical cases without associated valve pathology, except functional TR. Variables were statistically compared on TR classes and surgery-defined groups.
resultsMean age of the patients was 40.3±13 years; 19.9% had sinus venosus syndrome. TR severity was directly related to age, pulmonary systolic pressure, right ventricular and tricuspid annulus diameters, and heart failure class. TR ≥ 2 was found in 134 (65%) patients, while TR ≥ 3 in 56 (27.2%) patients. Tricuspid surgery was associated to shunt closure in 66 (32%) patients, almost all through valve repair; indication was directly related to age, right ventricular and tricuspid annulus diameters, and heart failure class ≥ 3. Tricuspid surgery was more efficient than isolated shunt closure in decreasing TR (79±23% vs. 36±26%; P=1.8 E-18). Device closure availability (last four years of the study) was associated with 1/3 reduction of surgical cases but increased the share of cases with TR>2 (> 51% vs. < 31%; P<0.05).
conclusionIn the era of device closure, surgery for adult ASD is less frequent, but the share of significant TR cases is in net increase. To avoid long-term postoperative TR, we plead for valve repair in all patients with severe TR and for considering repair in moderate TR at risk of persistence.
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