Late tricuspid surgery: predicting outcome with computed tomography

Abstract

Tricuspid regurgitation can progressively worsen years after left-sided heart valve surgery, requiring surgical intervention for which the prognostic factors are unclear. This study aimed to assess the prediction of surgical outcome using right ventricular function obtained from computed tomography. We prospectively enrolled 24 patients who underwent isolated tricuspid repair or replacement from 2005 to 2008. Right ventricular computed tomography was carried out before surgery. The primary endpoint was survival with symptomatic improvement after one year. Twelve patients survived with improvement of at least one New York Heart Association functional class, and 12 died or had no symptomatic improvement. All baseline characteristics, echocardiogram data, and surgical details were similar in both groups. Right ventricular computed tomography parameters including end-systolic volume, indexed end-systolic volume, end-diastolic volume, and indexed end-diastolic volume were significantly different between the two groups. We concluded that right ventricular function assessed by computed tomography can predict the surgical outcome in patients undergoing surgery for isolated late tricuspid regurgitation.