Additional tricuspid valve annuloplasty versus isolated closure for atrial septal defect with secondary moderate to severe tricuspid regurgitation: A propensity score matching study_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

CHEN Tianyu , LIU Xiaobing , YU Juemin , REN Qiushi , QIU Hailong , WEN Shusheng ,  ZHUANG Jian

1. Department of Cardiovascular Surgery, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, P. R. China;

Corresponding author：

ZHUANG Jian, Email: zhuangjian5413@163.com

Keywords：

Atrial septal defect; tricuspid regurgitation; tricuspid valve annuloplasty; transcatheter closure; propensity score matching

DOI：

10.7507/1007-4848.202208038

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Objective To compare the efficacy of additional tricuspid valve annuloplasty (TVP) and isolated closure for atrial septal defect (ASD) with moderate to severe tricuspid regurgitation (TR). Methods Clinical data of the patients diagnosed with ASD combined with secondary moderate to severe TR and treated in our hospital from January 2009 to June 2020 were retrospectively analyzed. Patients were divided into a TVP group and a non-TVP group based on whether TVP was performed simultaneously. The baseline data of two groups were matched with a ratio of 1∶1 propensity score. Results A total of 32 pairs from 257 patients were successfully matched. In the TVP group, there were 24 females and 8 males with an average age of 44.0±13.1 years. In the non-TVP group, there were 28 females and 4 males with an average age of 44.5±11.6 years. The TR area and estimated pulmonary artery pressure in the two groups were significantly decreased compared with preoperation (all P<0.001). The TR area (P=0.001) and the estimated pulmonary artery pressure (P=0.002) were decreased more significantly in the TVP group than those in the non-TVP group. Linear regression analysis showed that age and preoperative TR area had a positive correlation with TR area at follow-up (β=0.045 and 0.259, respectively, both P<0.05), while additional TVP had a negative correlation (β=–1.542, P=0.001). Conclusion Additional TVP can significantly reduce the TR area and pulmonary artery pressure, and elderly patients with severe TR before surgery should actively receive TVP.

Citation： CHEN Tianyu, LIU Xiaobing, YU Juemin, REN Qiushi, QIU Hailong, WEN Shusheng, ZHUANG Jian. Additional tricuspid valve annuloplasty versus isolated closure for atrial septal defect with secondary moderate to severe tricuspid regurgitation: A propensity score matching study. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2024, 31(4): 519-524. doi: 10.7507/1007-4848.202208038 Copy

1.	Abrahamyan L, Dharma C, Alnasser S, et al. Long-term outcomes after atrial septal defect transcatheter closure by age and against population controls. JACC Cardiovasc Interv, 2021, 14(5): 566-575.
2.	Humenberger M, Rosenhek R, Gabriel H, et al. Benefit of atrial septal defect closure in adults: Impact of age. Eur Heart J, 2011, 32(5): 553-560.
3.	Takaya Y, Akagi T, Kijima Y, et al. Functional tricuspid regurgitation after transcatheter closure of atrial septal defect in adult patients: Long-term follow-up. JACC Cardiovasc Interv, 2017, 10(21): 2211-2218.
4.	Kim HR, Jung SH, Park JJ, et al. Risk analysis of the long-term outcomes of the surgical closure of secundum atrial septal defects. Korean J Thorac Cardiovasc Surg, 2017, 50(2): 78-85.
5.	Bach Y, Abrahamyan L, Lee DS, et al. Long-term outcomes of adults with tricuspid regurgitation following transcatheter atrial septal defect closure. Can J Cardiol, 2022, 38(3): 330-337.
6.	Chen L, Shen J, Shan X, et al. Improvement of tricuspid regurgitation after transcatheter ASD closure in older patients. Herz, 2018, 43(6): 529-534.
7.	Nassif M, van der Kley F, Abdelghani M, et al. Predictors of residual tricuspid regurgitation after percutaneous closure of atrial septal defect. Eur Heart J Cardiovasc Imaging, 2019, 20(2): 225-232.
8.	Stout KK, Daniels CJ, Aboulhosn JA, et al. 2018 AHA/ACC guideline for the management of adults with congenital heart disease: Executive summary: A report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation, 2019, 139(14): e637-e697.
9.	Toyono M, Krasuski RA, Pettersson GB, et al. Persistent tricuspid regurgitation and its predictor in adults after percutaneous and isolated surgical closure of secundum atrial septal defect. Am J Cardiol, 2009, 104(6): 856-861.
10.	Fang F, Wang J, Yip GW, et al. Predictors of mid-term functional tricuspid regurgitation after device closure of atrial septal defect in adults: Impact of pre-operative tricuspid valve remodeling. Int J Cardiol, 2015, 187: 447-452.
11.	Abohamar MD, Ashmawy MM, Kasem HK, et al. Original article-predictors of persistent functional tricuspid regurgitation after transcatheter closure of atrial septal defect and its relationship to tricuspid valve remodeling. J Saudi Heart Assoc, 2021, 33(1): 53-60.

1. Abrahamyan L, Dharma C, Alnasser S, et al. Long-term outcomes after atrial septal defect transcatheter closure by age and against population controls. JACC Cardiovasc Interv, 2021, 14(5): 566-575.
2. Humenberger M, Rosenhek R, Gabriel H, et al. Benefit of atrial septal defect closure in adults: Impact of age. Eur Heart J, 2011, 32(5): 553-560.
3. Takaya Y, Akagi T, Kijima Y, et al. Functional tricuspid regurgitation after transcatheter closure of atrial septal defect in adult patients: Long-term follow-up. JACC Cardiovasc Interv, 2017, 10(21): 2211-2218.
4. Kim HR, Jung SH, Park JJ, et al. Risk analysis of the long-term outcomes of the surgical closure of secundum atrial septal defects. Korean J Thorac Cardiovasc Surg, 2017, 50(2): 78-85.
5. Bach Y, Abrahamyan L, Lee DS, et al. Long-term outcomes of adults with tricuspid regurgitation following transcatheter atrial septal defect closure. Can J Cardiol, 2022, 38(3): 330-337.
6. Chen L, Shen J, Shan X, et al. Improvement of tricuspid regurgitation after transcatheter ASD closure in older patients. Herz, 2018, 43(6): 529-534.
7. Nassif M, van der Kley F, Abdelghani M, et al. Predictors of residual tricuspid regurgitation after percutaneous closure of atrial septal defect. Eur Heart J Cardiovasc Imaging, 2019, 20(2): 225-232.
8. Stout KK, Daniels CJ, Aboulhosn JA, et al. 2018 AHA/ACC guideline for the management of adults with congenital heart disease: Executive summary: A report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation, 2019, 139(14): e637-e697.
9. Toyono M, Krasuski RA, Pettersson GB, et al. Persistent tricuspid regurgitation and its predictor in adults after percutaneous and isolated surgical closure of secundum atrial septal defect. Am J Cardiol, 2009, 104(6): 856-861.
10. Fang F, Wang J, Yip GW, et al. Predictors of mid-term functional tricuspid regurgitation after device closure of atrial septal defect in adults: Impact of pre-operative tricuspid valve remodeling. Int J Cardiol, 2015, 187: 447-452.
11. Abohamar MD, Ashmawy MM, Kasem HK, et al. Original article-predictors of persistent functional tricuspid regurgitation after transcatheter closure of atrial septal defect and its relationship to tricuspid valve remodeling. J Saudi Heart Assoc, 2021, 33(1): 53-60.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Additional tricuspid valve annuloplasty versus isolated closure for atrial septal defect with secondary moderate to severe tricuspid regurgitation: A propensity score matching study

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