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- Titel:
Right ventricular function in Marfan patients remains stable despite multiple cardiac interventions.
- Dokumenttyp:
- Journal Article; Observational Study
- Autor(en):
- Mihalj, Maks; Nucera, Maria; Ferro, Cyril; Mosbahi, Selim; Haynes, Alan; Yildiz, Murat; Heinisch, Paul Philipp; Schoenhoff, Florian S
- Abstract:
- OBJECTIVES: Mitral valve regurgitation and left ventricular dysfunction are cardiovascular symptoms of Marfan syndrome. There is a paucity of information on tricuspid valve regurgitation and right ventricular function. In patients with Marfan syndrome, we looked at long-term changes in right ventricular function, tricuspid valve regurgitation and freedom from tricuspid valve repair. METHODS: Retrospective-observational single-centre analysis on right ventricular function and tricuspid regurgitation in Marfan patients who underwent surgery with cardioplegic arrest between 1995 and 2020. Patients were followed-up from 1st operation until death, with echocardiographic changes analysed longitudinally. Composite end point was tricuspid annular plane systolic excursion (TAPSE) ≤16 mm, severe tricuspid regurgitation or tricuspid repair. RESULTS: The study included 135 patients who underwent 193 operations, 58 of those were reoperations in 40 patients. Median age at 1st operation was 35 years [interquartile range (IQR) 26-46], median follow-up was 8.0 years (IQR 3.0-16.0) and median time to 1st reoperation was 7.5 years (IQR 3.4-12.5). The composite end point occurred in 81 observations in 40 patients, mostly as a recurrent event, after median 7.0 years (IQR 1.0-13.0). Ten-year cumulative incidence for composite end point was 22.0% (95% CI 15-31) and 9.0% (95% CI 4.4-16) for new-onset TAPSE ≤16 mm, but no significant change in TAPSE was observed at 10 years. Tricuspid regurgitation was associated with increased risk of annual progression (P < 0.001), but not clinically relevant at 10 years. Actuarial 10-year survival was 91.1%. CONCLUSIONS: In Marfan patients with a history of cardiac surgery and subsequent reoperations, the right ventricular function remains stable. The incidence of severe tricuspid regurgitation and tricuspid repair remain low.
- Zeitschriftentitel:
- Eur J Cardiothorac Surg
- Jahr:
- 2024
- Band / Volume:
- 66
- Heft / Issue:
- 3
- Volltext / DOI:
- doi:10.1093/ejcts/ezae313
- PubMed:
- http://view.ncbi.nlm.nih.gov/pubmed/39150778
- Print-ISSN:
- 1010-7940
- TUM Einrichtung:
- Klinik für Chirurgie angeborener Herzfehler und Kinderherzchirurgie (DHM) (Prof. Hörer)
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