Tricuspid valve surgery and intraoperative echocardiography
Factors affecting survival, clinical outcome, and echocardiographic success
Christopher T. Bajzer, MD*,
William J. Stewart, MD, FACC*,
Delos M. Cosgrove, MD ,
Sami J. Azzam, MD ,
Kristopher L. Arheart, EdD and
Allan L. Klein, MD, FACC*
* Department of Cardiology, The Cleveland Clinic Foundation, Cleveland, Ohio, USA
Department of Cardiothoracic Surgery, The Cleveland Clinic Foundation, Cleveland, Ohio, USA
Department of Biostatistics and Epidemiology, The Cleveland Clinic Foundation, Cleveland, Ohio, USA
Department of Cardiology, MetroHealth Medical Center, Cleveland, Ohio, USA
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Figure 1 Diagram of the patient population demonstrating the use of preoperative, intraoperative, and postoperative echocardiography.
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Figure 2 Intraoperative color flow Doppler evaluation of tricuspid valve dysfunction using transesophageal echocardiography demonstrating: top, moderately severe (3+) tricuspid regurgitation prior to surgical repair; middle, severe (4+) tricuspid regurgitation after first repair effort; and bottom, mild (1+) tricuspid regurgitation after a second cardiopulmonary bypass run for a second and final repair effort.
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Figure 3 Immediate outcome of valvular surgery facilitated by the use of intraoperative echocardiography.
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Figure 4 Relative risk of death, adverse clinical event, death or adverse clinical event, and odds ratio of echocardiographic failure after tricuspid valve surgery.
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Figure 5 Top, Kaplan-Meier survival probability, and bottom, event-free survival probability after surgery to correct a dysfunctional tricuspid valve.
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