Predictors of Tricuspid Valve Anulus Dilation in a Heart Recipient Population

Abstract Background Tricuspid valve regurgitation in reported in >20% of heart recipients. It severity has not only clinical impact, but it is also associated with increased mortality. Risk factors for developing tricuspid valve dysfunction include allograft rejection, donor/recipient pericardial...

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Bibliographic Details
Published in:Transplantation proceedings 2016-06, Vol.48 (5), p.1742-1745
Main Authors: Urbanowicz, T, Michalak, M, Kociemba, A, Straburzyńska-Migaj, E, Katarzyński, S, Grajek, S, Jemielity, M
Format: Article
Language:English
Subjects:
Dilatation, Pathologic
Echocardiography - adverse effects
Female
Heart Atria - pathology
Heart Transplantation - adverse effects
Humans
Magnetic Resonance Angiography
Male
Middle Aged
Organ Size
Risk Factors
Surgery
Tissue Donors
Transplant Recipients
Tricuspid Valve - pathology
Tricuspid Valve Insufficiency - etiology
Tricuspid Valve Insufficiency - pathology
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Summary:Abstract Background Tricuspid valve regurgitation in reported in >20% of heart recipients. It severity has not only clinical impact, but it is also associated with increased mortality. Risk factors for developing tricuspid valve dysfunction include allograft rejection, donor/recipient pericardial cavity mismatch, preoperative transpulmonary gradient and vascular resistance, biatrial anastomosis technique, and biopsy-induced injury. Tricuspid valve annulus distention is reported to causative factor for most common type of tricuspid valve dysfunction after heart transplantation. The aim of the study was to estimate possible early predictors for tricuspid valve regurgitation after orthotopic heart transplantation performed with standard Lower-Shumway technique on magnetic resonance imaging studies. Methods A total of 20 patients (18 men and 2 women) with a mean age of 45 ± 12 years were enrolled into the study. Echocardiographic evaluation followed by magnetic resonance studies were performed. The mean duration from time of transplantation was 34 ± 12 months. Magnetic resonance and echocardiographic imaging focused on tricuspid valve annulus diameter and atrium dimensions. Results The was a progressive distension of tricuspid valve annulus observed during the follow-up period. Mean tricuspid valve diameter increased from 3.0 ± 0.3 to 3.34 ± 0.3 mm ( P  < .05). There was a positive correlation observed between recipient native right atrium and overall right atrium diameter and tricuspid valve diameter distension. Conclusions Overall right atrium diameter and native recipient right atrium diameter were found to be a risk factor for tricuspid valve annulus distension.
ISSN:0041-1345
1873-2623
DOI:10.1016/j.transproceed.2016.01.093