Tricuspid annular diameter and right ventricular volume on preoperative cardiac CT can predict postoperative right ventricular dysfunction in patients who undergo tricuspid valve surgery. (1st August 2019)

• Record Type: Journal Article
• Authors: Suh, Young Joo; Kim, Darae; Shim, Chi Young; Han, Kyunghwa; Chang, Byung-Chul; Lee, Sak; Hong, Geu-Ru; Choi, Byoung Wook; Kim, Young Jin
• Is Part Of: International journal of cardiology. Volume 288(2019)
• Page Start: 44
• Page End: 50
• Publication Date: 2019-08-01
• Subjects: Valvular heart disease -- Computed tomography -- Tricuspid regurgitation -- Right ventricular dysfunction -- Cardiovascular surgery; Cardiology -- Periodicals; Electronic journals; 616.12
• DOI: 10.1016/j.ijcard.2019.03.002
• Languages: English
• ISSNs: 0167-5273

Abstract

Abstract: Background: We investigated the predictive value of preoperative computed tomography (CT)-derived tricuspid annular and right ventricular (RV) parameters for postoperative RV dysfunction in patients undergoing tricuspid valve (TV) surgery. Methods: We retrospectively reviewed clinical, transthoracic echocardiography (TTE), and CT data of 100 consecutive patients who underwent cardiac CT and subsequently received TV surgery. Preoperative cardiac CT and TTE parameters were analyzed, including TV annulus diameter and RV size. Univariate and multivariate logistic regression analyses were performed to identify significant predictors for postoperative RV dysfunction, both in the entire study population and in the subgroup of patients without preoperative RV dysfunction. Results: Postoperative RV dysfunction occurred in 46% of all patients. In the multivariate logistic regression analysis, longer TV annulus diameter (>29.3 mm/m 2 on four-chamber view; (odds ratio [OR] 3.56, 95% confidence interval [CI] 1.13–11.24), larger RV volume (RV end-diastolic volume/body surface area > 128.8 ml/m 2 ) on CT (OR 3.85, 95% CI 1.24–11.98) and presence of preoperative RV dysfunction on TTE (OR 11.96, 95% CI 2.8–50.99) were independent predictors for postoperative RV dysfunction in the entire study population ( P < 0.05). Among patients without preoperative RV dysfunction, longer TV annulus diameter (OR 4.02, 95% CI 1.20–13.41) and larger RV volume on CT (OR 6.09, 95% CI 1.87–19.80) were independent predictors for postoperative RV dysfunction ( P < 0.05). Conclusions: Preoperative assessment of cardiac CT imaging–based TV annular diameter and RV volume can provide independent information for predicting postoperative RV dysfunction in patients undergoing TV surgery. Highlights: Postoperative RV dysfunction occurred in 46% after tricuspid valve surgery. Longer TV annulus diameter and larger RV volume on CT were predictors. Predictive information from TV annulus diameter and RV volume on preoperative CT