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Concomitant tricuspid insufficiency in aortic stenosis:correction approach

Authors: I.I. Skopin, M.S. Latyshev, I.V. Slivneva, A.V. Vavilov, T.V. Asatryan, I.Yu. Farulova

Company: Bakoulev National Medical Research Center for Cardiovascular Surgery, Rublevskoe shosse, 135, Moscow, 121552, Russian Federation

Type:  Original Research


DOI: https://doi.org/10.24022/0236-2791-2018-60-4-301-308

For citation: Skopin I.I., Latyshev M.S., Slivneva I.V., Vavilov A.V., Asatryan T.V., Farulova I.Yu. Concomitant tricuspid insufficiency in aortic stenosis: correction approach. Russian Journal of Thoracic and Cardiovascular Surgery. 2018; 60 (4): 301–8 (in Russ.). DOI: 10.24022/0236-2791-2018- 60-4-301-308

Received / Accepted:  19.02.2018/01.03.2018

Keywords: concomitant tricuspid regurgitation aortic stenosis tricuspid valve de Vega annuloplasty

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Abstract

Objective. To define operative tactics of concomitant tricuspid regurgitation (TR) correction in aortic stenosis (AS).

Material and methods. The results of surgery for concomitant TR in patients with isolated AS performed in the last 11 years (n =101) were analyzed. Two groups of patients were identified: the 1st group with isolated AS correction (n=50), and the 2nd group with AS and TR correction (n =51).

Results. Both groups were comparable in terms of anthropometric indicators and gender. The grade of concomitant TR was 1.08±0.27 in the 1st group and 2.1±0.7 in the 2nd group; diameter of tricuspid annulus in the 1st group was 34.1±3.53 mm vs. 38.1±4.72 mm in the 2nd group. In the late postoperative period the grade of concomitant TR: decreased in 8% of cases (n =4) in the 1st group vs. 64.7% (n =33) in the 2nd group, increased in 14% of cases (n =7) in the 1st group vs. 3.9% (n = 2) in the 2nd group, did not change in 78% of cases (n =39) in the 1st group vs. 31.4% (n =16) in the 2nd group. According to the results of the study, the following factors influencing the development of residual TR were revealed: the diameter of tricuspid annulus ≥35.38±3.50 mm, pulmonary arterial systolic pressure >32.50±8.47 mm Hg, the presence of atrial fibrillation or pacemaker, mitral regurgitation >2 grade.

Conclusion. In the presence of these factors, patients with isolated aortic stenosis and mild or moderate degree of tricuspid insufficiency
along with prosthetics of the aortic valve are recommended to tricuspid valve annuloplasty.

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About Authors

  • Ivan I. Skopin, Dr. Med. Sc., Professor, Head of Department, Director, Institute of Coronary and Vascular Surgery, orcid.org/0000-0001-7411-202X;
  • Mikhail S. Latyshev, Postgraduate, orcid.org/0000-0003-1771-4264;
  • Inessa V. Slivneva, Cand. Med. Sc., Researcher, Ultrasound Diagnostic Specialist, orcid.org/0000-0001-7935-7093;
  • Aleksandr V. Vavilov, Cardiovascular Surgeon, orcid.org/0000-0002-0488-5630;
  • Tigran V. Asatryan, Researcher, orcid.org/0000-0002-0141-5481;
  • Inga Yu. Farulova, Researcher, orcid.org/0000-0003-4060-5760

Chief Editor

Elena Z. Golukhova, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, Director of Bakoulev National Medical Research Center for Cardiovascular Surgery


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