Improvement of the Left Ventricular Function after Tricuspid Valve Plasty for Traumatic Tricuspid Regurgitation

Traumatic tricuspid valve regurgitation: A two case series

Traumatic tricuspid valve injury is rare, accounting for 0.02% of traumatic injuries. The majority of cases result from blunt force trauma to the chest, however penetrating injuries have been documented in literature. Patients' can be in the full spectrum of disease, from asymptomatic to cardiogenic shock. Indications for surgery include right heart failure or evidence of right heart volume overload in the setting of significant tricuspid regurgitation. Early surgical repair is warranted to preserve right ventricular function. Surgery also needs to be planned in conjunction with the patients' other injuries. In some cases, it may be beneficial for surgery to be delayed whilst the patient is closely observed, in order for the patient to recover from concomitant injuries. We report two cases of tricuspid regurgitation in the context of blunt trauma, and our approach to the management of these patients.

The role of left atrial strain in patients with functional tricuspid regurgitation before and after annuloplasty: a long-term follow-up study

Background

Functional tricuspid regurgitation (TR) is common among patients with left heart disease and may recur during the follow-up period after selective tricuspid valve annuloplasty (TVA). This study aims to analyse the relationship between left atrial (LA) strain and the degree of preoperative functional TR and to explore the role of LA strain in predicting TR recurrence.

Methods

This study included 63 patients with rheumatic mitral stenosis who underwent mitral valve replacement and concomitant TVA. Additionally, 20 healthy controls were enrolled. Preoperative conventional LA echocardiographic parameters and LA strain were measured. The association between LA strain and preoperative functional TR severity was analysed by Pearson correlation. Predictors of recurrent TR were determined by multivariate logistic regression analyses.

Results

Compared with the control group, the mitral stenosis group developed a significant impairment in terms of LA strain. The degree of preoperative functional TR exhibited moderate correlations with LA reservoir strain (r = − 0.57) and LA conduit strain (r = 0.48). During a median follow-up period of 66.4 ± 36.4 months, TR recurred in 18 patients. Preoperative LA reservoir strain and the mean transmitral gradient were predictors of postoperative TR recurrence. When the two indexes were combined to establish a prediction, the sensitivity and specificity of prediction increased. The area under the receiver operating characteristic curve of the combined indicator was higher than those of the single indicators (0.90 vs. 0.70 and 0.72).

Conclusions

LA strain correlates with preoperative functional TR severity in patients with rheumatic mitral stenosis. The LA reservoir strain and preoperative mean transmitral gradient are independent predictive factors for recurrent TR after TVA.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12947-021-00264-z.