Tricuspid regurgitation: Frequency, clinical presentation, management and outcome among patients with severe left-sided valvular heart disease in Europe. Insights from the ESC-EORP Valvular Heart Disease II survey.
[en] AIMS: Tricuspid regurgitation (TR) is commonly observed in patients with severe left-sided valvular heart disease (VHD). This study sought to assess TR frequency, management and outcome in this population. METHODS AND RESULTS: Among 6883 patients with severe native left-sided VHD or previous left-sided valvular intervention enrolled in the EURObservational Research Programme prospective VHD II survey, moderate or severe TR was very frequent in patients with severe mitral VHD (30% when mitral stenosis, 36% when mitral regurgitation [MR]), especially in patients with secondary MR (46%), and rare in patients with severe aortic VHD (4% when aortic stenosis, 3% when aortic regurgitation). An increase in TR grade was associated with a more severe clinical presentation and a poorer 6-month survival (p < 0.0001). Rates of concomitant tricuspid valve (TV) intervention at the time of left-sided heart valve surgery were high at the time of mitral valve surgery (50% when mitral stenosis, 41% when MR). Concordance between class I indications (patients with severe TR) for concomitant TV surgery at the time of left-sided valvular heart surgery according to guidelines and real-practice decision-making was very good (88% overall, 95% in patients operated on for MR). CONCLUSION: In this large international prospective survey among patients with severe left-sided VHD, moderate/severe TR was frequent in patients with mitral valve disease and was associated with a poorer outcome as TR grade increased. In patients with severe TR, compliance to guidelines for class I indications for concomitant TV surgery at the time of left-sided heart valve surgery was very good.
Disciplines :
Cardiovascular & respiratory systems
Author, co-author :
Dreyfus, Julien ; Cardiology Department, Centre Cardiologique du Nord, Saint-Denis, France.
Komar, Monika; Department of Heart and Vessel Disease, Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland.
Attias, David; Cardiology Department, Centre Cardiologique du Nord, Saint-Denis, France.
De Bonis, Michele; Vita-Salute San Raffaele University, Milan, Italy. ; Department of Cardiac Surgery, IRCCS San Raffaele Hospital, Milan, Italy.
Ruschitzka, Frank; Clinic of Cardiology, University Heart Centre, University Hospital, Zurich, Switzerland.
Popescu, Bogdan A; University of Medicine and Pharmacy 'Carol Davila' - Euroecolab, Emergency Institute for Cardiovascular Diseases 'Prof. Dr. C.C. Iliescu', Bucharest, Romania.
Laroche, Cécile; EURObservational Research Programme, European Society of Cardiology, Sophia-Antipolis, France.
Tribouilloy, Christophe; Department of Cardiology, University Hospital Amiens, Amiens, France.
Bogachev Prokophiev, Alexander; Heart Valves Surgery Department, Meshalkin National Medical Research Center, Novosibirsk, Russia.
Mizariene, Vaida; Department of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania.
Bax, Jeroen J; Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands.
Maggioni, Aldo Pietro; EURObservational Research Programme, European Society of Cardiology, Sophia-Antipolis, France.
Messika-Zeitoun, David; Department of Cardiology, University of Ottawa Heart Institute, Ottawa, ON, Canada.
Vahanian, Alec; Université de Paris, Paris, France.
Iung, Bernard; AP-HP, Cardiology Department, Bichat Hospital, Université de Paris, INSERM, Paris, France.
on behalf of the EORP VHD II Registry Investigators, Group
Tricuspid regurgitation: Frequency, clinical presentation, management and outcome among patients with severe left-sided valvular heart disease in Europe. Insights from the ESC-EORP Valvular Heart Disease II survey.
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